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GIFT  or 

DR.  FRED  M.   HAYES 


r 


TEXT    BOOK 


OF 


VETERINARY    MEDICINE 


BY 


JAMES  LAW,  F.R.C.V.S. 


Director  of  the  New  York  SUte  Veterinary  College 
Cornell  UnWersity,  Ithaca,  N.  Y. 


VOL.    Ill 


SECOND  EDITION 

REVISED  AND  ENLARGED 


DISEASES  OF  THE  NERVOUS  SYSTEM— GENITO- 
URINARY ORGANS— EYE— SKIN  :  CONSTI- 
TUTIONAL DISEASES 

Mi.KARY 

UNIVfiRSIfV^  OP  CALIFORNIA" 
DAVIS 

ITHACA 

PUBLI8HBD    BY  TRK  AUTHOR 

1905 

]/ 


Copyright  by 

JAMKS  LAW 

1900 


PRRSS  OF 

ANDRUS  &  CHURCH 

ITHACA,  If.  Y. 


VETERINARY  MEDICINE. 


DISEASES  OF  THE  NERVOUS  SYSTEM. 

Nervous  control  of  bodily  functions  :  affected  through  disease  of  nerve 
centres  or  nerve  trunks,  sensory,  motor,  vaso-motor,  etc.  Modes  of  im- 
paired nervous  function  :  objective  ;  subjective.  Nervous  characteristics 
in  different  breeds,  individuals,  sexes,  castrated  animals.  Nervous  disorder 
from  microbian  toxins,  narcotics,  nervous  stimulants,  etc. 

All  bodily  functions  are  more  or  less  directly  controlled  by  the 
nervous  system,  hence  nervous  troubles  are  interwoven  with  the 
diseases  of  all  other  organs.  Disorder  of  the  nerve  centres  or 
nerve  trunks  affects  the  most  distant  parts  over  which  these  pre- 
side, or  to  and  from  which  they  convey  nervous  impulse.  In 
different  cases  we  see  this  operating  through  the  sensory  or 
motor  functions,  through  lack  of  coordination  or  of  balance, 
through  modification  of  the  circulation,  respiration,  secretion, 
absorption,  nutrition,  metabolism,  special  sensation,  intellection, 
emotion,  etc.  These  manifestations  are  less  evident  or  less  diag- 
nostic in  the  lower  animal,  because  we  cannot  fully  avail  of  the 
subjective  symptoms.  While  the  human  patient  can  tell  us  his 
feelings  and  experience  in  their  regular  order  and  succession,  we 
can  only  infer  most  of  these  in  the  animal,  through  dependent 
objective  symptoms.  In  many  cases  we  cannot  even  infer  for 
lack  of  dependent  symptoms. 

The  practitioner  must  carefully  watch  for  and  accurately  ob- 
serve all  objective  symptoms,  and  seek  to  rightly  interpret  them. 
Among  other  things  he  must  note  the  nervous  conformation,  or- 
ganization and  susceptibility  ;  the  hereditary  nervous  characteris- 
tics as  seen  in  breeds,  temperament,  habit,  aptitude  to  learn, 
docility,  instinct,  intelligence,  emotions  and  affections,  and  judge 
the  case  in  the  light  of  these.  Similarly  he  must  take  into  ac- 
count the  hereditary,  racial  and  individual  irritability,  obstinacy, 
restiveness,  vice,  alertness,  sluggishness,  stupidity,  moroseness, 
and  diagnose  accordingly.  Congestion,  anaemia,  coma,  paresis, 
paralysis,  may  result  from  the  nervous  disorder  and  offer  valu- 


jj^^^"^ 


2  Veterinary  Medicine, 

able  concurrent  testimony  to  the  same.  Allowance  must  always 
be  made  for  the  use  to  which  the  animal  has  been  put,  thvis  sexu- 
ality tells  strongly  in  the  horse,  bull,  boar,  or  ram  which  has 
been  used  for  breeding  and  has  become  relatively  indocile  and 
even  dangerous  ;yi7^^  tells  in  a  horse  that  **  shows  his  com", 
and  in  the  dog  fed  on  flesh ;  the  comparatively  untrained  English 
race  horse  is  far  less  docile  than  the  one  inured  to  saddle  or  har- 
ness and  the  horse  fresh  from  the  range,  though  previously 
trained,  is  far  less  tractable  than  the  one  in  steady  work.  The 
sexual  products  are  especially  liable  to  modify  the  temper,  hence 
the  docility  of  the  gelding,  and  castrated  mare,  and  the  undis- 
turbed life  and  steady  growth  and  fattening  of  castrated  animals 
from  cattle  to  capons 

The  products  of  certain  diseases  and  many  drugs  derange  the  in- 
nervation and  intellection.  Of  this  we  have  examples  in  the 
hebetude  of  the  victims  of  milk  sickness  and  dourine,  in  the  wild 
delirium  of  rabies,  in  the  varied  nervous  disorders  that  attend  on 
the  use  of  narcotics,  essential  oils,  alcohol,  chloral,  sulphonal, 
trional,  strychnia,  lead,  phosphorus,  arsenic,  etc. 


GENERAL  SYMPTOMATOLOGY  AND  DIAGNOSIS. 

Motor  disorders :  paralysis,  paresis,  hemiplegia,  crossed  hemiplegia,  spinal 
hemiplegia,  paraplegia,  monoplegia,  local  palsy,  pseudo-paralysis,  spasm, — 
tonic,  clonic,  tremor,  hemispasm,  monospasm,  spasm  of  eyeball,  spasm  of 
head,  paraplegic  spasm,  general  spasms — convulsions,  local  spasms.  Inco- 
ordination. Staggering.  Reflex  action.  Morbid  reflex :  increased  reflex, 
reflex  tonic  spasm. 

It  seems  desirable  to  note  specially  some  of  the  more  prominent 
morbid  nervous  phenomena  and  conditions,  with  lesions  or  other 
conditions  which  cause  them,  before  considering  what  are  usually 
recognized  as  special  diseases. 

MOTOR  DISORDERS. 

Paralysis  (Akinesis)  is  loss  of  voluntary  or  involuntary 
muscular  movement  through  defective  inervation. 

Paresis  is  a  paralysis  which  is  partial  in  degree  ;  power  of 
motion  is  impaired  but  not  completely  lost. 


General  Symtomatology  and  Diagnosis,  3 

Hemiplegia  is  the  loss  of  voluntary  motion  in  many  muscles 
on  one  side  of  the  face  or  body.  In  general  hemiplegia,  the  fol- 
lowing muscles  are  usually  excepted : — muscles  of  the  tongue,  of 
mastication,  of  the  eye,  of  respiration,  of  the  neck  and  trunk 
generally  and  of  the  proximal  part  of  the  limbs.  The  hind  limbs 
are  usually  most  afiFected,  and  muscles  that  are  most  exclusively 
under  the  control  of  the  will — those  dominated  by  the  cortical 
centres  of  the  brain.  When  due  to  a  clot  on  the  brain  or  de- 
generation it  occurs  on  the  side  opposite  to  that  occupied  by  the 
dot,  on  accotmt  of  the  motor  fibres  crossing  at  the  anterior  pyra- 
mids of  the  medulla.  Hemianaesthesia  is  a  rare  attendant  and 
when  present  is  often  on  the  side  opposite  to  the  hemiplegia. 
Sensory  fibres  cross  in  the  spinal  cord,  and  the  lesion  is  probably 
spinal. 

Crossed  Hemiplegia  is  motor  paralysis  of  certain  cephalic 
nerves  (3d,  7th,  5th,  6th,  and  8th, )  on  the  3ame  side  with  the  clot 
or  lesion,  and  of  the  muscles  of  the  trunk  on  the  other  side.  The 
cranial  nerves  proceed  to  muscles  on  the  same  side  as  their 
origin,  while  filaments  going  to  the  trunk  through  the  spinal 
cord,  cross  in  the  pyramids  (motor),  or  spinal  cord  (sensory). 
In  crossed  hemiplegia,  hemianaesthesia  is  common  with  both 
forms  of  paralysis  on  one  side. 

Spinal  Hemiplegia  has  the  face  and  head  sound  (except 
sometimes  the  iris),  and  half  the  body  paralyzed  on  the  side  on 
which  the  spinal  lesion  (clot)  exists.  If  anaesthesia  exists  it  is  on 
the  side  opposite  to  the  lesion  and  posterior  to  it — the  sensory 
filaments  crossing  just  before  leaving  the  cord. 

Paraplegia  is  loss  of  voluntary  power  of  one  transverse  half 
of  the  body  ;  usually  the  posterior,  and  affects  the  tail,  and  has 
coincident  anaesthesia,  being  due  to  a  spinal  lesion.  Anal  and 
vesical  sphincters  may  or  may  not  be  paralyzed  according  as  the 
lesions  implicate  their  respective  spinal  centres  or  not.  If  there 
is  neither  anaesthesia  nor  vesical  paralysis  the  lesion  may  be  cere- 
bral, in  the  paracentral  lobes  of  both  hemispheres  (meso-vertix 
at  the  fissure  of  Rolando. ) 

Monoplegia  is  a  circumscribed  paralysis,  as  of  one  limb,  or  on 
one  side  of  the  face,  one  group  of  muscles  or  a  single  muscle. 
It  may  be  due  to  cerebral,  spinal  or  nervous  lesion.  Cerebral 
monoplegias  are  distinguished  by  :  ist,  initial  spasm ;  2nd,   ab- 


4  Veterinary  Medicine, 

sence  of  anaesthesia  ;  3d,  persistence  of  nutrition  ;  4th,  paralysis 
greatest  in  the  distal  portion  of  the  member. 

Localized  Paralysis  is  usually  due  to  the  lesion  of  a  nerve,  and 
is  both  motor  and  sensory.  If  due  to  a  spinal  lesion  it  usually 
affects  one  or  more  groups  of  muscles.  In  case  the  lesion  is  in 
the  nerve,  be  guided,  in  investigating  it,  by  Van  der  Kolk's  law, 
that  the  sensory  fibres  are  usually  distributed  in  the  skin  corre- 
sponding to  the  muscles  which  receive  the  motor  fibres. 

Pseudo-paralysis  occurs  from  muscular  disease,  injury,  in- 
flammation or  degeneration,  and  has  no  appreciable  central  nor 
nervous  lesion  nor  anaesthesia. 

Spasm  (^Hyperkinesis)  ;  abnormal  violent  muscular  contrac- 
tions with  or  without  loss  of  consciousness. 

Tonic  {tetanic)  Spasm  is  violent  and  continuous. 

Clonic  Spasm  is  rapidly  intermittent : — Contractions  and  re- 
laxations. 

Tremor  {trembling)  consists  in  small,,  intermittent,  involun- 
tary contraction. 

Hemispasm  affects  the  face,  or  limbs,  or  both,  on  one  side  of 
the  body  and  may  precede  hemiplegia. 

Monospasm  affects  one  limb,  one  group  of  muscles  or  a 
single  muscle.  It  may  be  due  to  lesion  of  the  brain,  of  the 
spinal  cord  or  of  the  nerves.  Thus  it  may  imply  commencing 
disease  of  the  njoter  centres  or  tracts. 

Spasms  of  the  Eyeballs  (rolling  of  globe  to  one  side)  and 
Spasms  of  the  Eyeballs  and  Head,  are  important  indications 
of  apoplexy.  They  imply  disorder  (commencing  irritation)  of 
the  cerebral  motor  areas.  Advanced  disease  would  probably  de- 
termine hebetude,  coma,  drowsiness,  or  palsy.  If  epileptiform 
it  turns  away  from  the  lesion.  If  hemiplegic  it  turns  toward  the 
lesion  and  away  from  the  paralysis.  If  lesion  of  the  pons  it 
turns  away  from  the  lesion. 

Paraplegic  Spasm  is  a  tonic  spasm,  partial  in  degree,  caus- 
ing stiff,  tetanoid  (spastic)  walk.  In  all  four  extremities  there 
may  be  mixed  paresis  and  contraction.  This  often  attends  on 
hemorrhage  into  the  meninges. 

General  Spasms,  convulsions  as  in  Eclampsia,  Epilepsy, 
Chorea,  Tetanus. 

Local  Spasms  may  be  rhythmic  or  not,  in  slight  cases  to  be 


General  Symtamatology  and  Diagnosis,  5 

seen  only  in  the  eyelids  or  superficial  muscles  as  twitching,  and 
occur  in  neurasthenia,  or  in  poisoning  by  strychnia,  brucia  and 
other  motor  nerve  poisons. 

Incoordination  {Dyskinesis)  is  the  lack  of  the  harmonious 
balanced  movement  of  the  various  groups  of  muscles.  Coordina- 
tion of  movement  is  due  to  a  special  mechanism  in  the  spinal  cord, 
and  extending  forward  through  the  medulla  oblongata,  pons,  and 
crura  cerebri  to  the  floor  of  the  third  ventricle.  In  the  form  of 
ataxia  (lack  of  power  of  muscular  control)  it  is  usually  the  result 
of  degeneration  (sclerosis)  of  the  superior  columns  of  the  cord, 
of  the  medulla,  pons  or  crura.  It  may  occur  from  degeneration 
or  destructive  change  in  the  cerebellum,  or  from  disease  or  sec- 
tion of  the  posterior  roots  of  spinal  nerves,  or  finally  from  the 
action  of  certain  narcotic  poisons  (ptomaines,  toxins). 

Staggering  (Htubaiion)  occurs  from  lesions  of  the  cerebellum, 
medulla  or  pons ;  also  from  alcohol,  opium,  and  other  narcotics. 

Reflex  Action .  The  normal  stimulation  of  different  functions, 
motor,  secretory,  circulatory,  etc. ,  depends  on  the  nerve  centres 
in  the  spinal  cord,  which  aVe  roused  into  action  by  a  centripetal 
impulse  derived  from  a  distant  part.  Thus  the  balanced  contrac- 
tion of  the  different  muscles  which  preserves  the  equilibrium  of 
the  body,  depends  on  the  apprehension  by  the  nerve  centres,  con- 
sciously or  subconsciously,  of  such  contractions  (muscular  sense), 
and  it  is  largely  under  the  control  of  the  will.  Here  three  im- 
pulses act  cobrdinately  :  ist,  the  afferent  impulse  from  the  mus- 
cle to  the  nerve  centre  ;  2d,  the  efferent  impulse  from  the  nerve 
centre  to  the  muscle  ;  and  3d,  the  inhibitory  or  controlling,  vol- 
untary impulse  from  the  sensorium  to  the  nerve  centre  involved. 
In  another  case,  savory  odors,  sapid  flavors  and  masticatory  move- 
ments cause  a  free  secretion  from  the  salivary  glands.  Again, 
the  scratching  of  a  dog's  breast  causes  him  to  move  his  hind  limb 
as  if  he  were  himself  doing  the  scratching.  Again,  the  pricking 
of  a  limb  causes  the  prompt,  even  if  involuntary,  contraction  of 
its  muscles  to  withdraw  it  from  the  source  of  irritation. 

Morbid  Reflex.  Reflex  action  may  be  modified  in  various 
ways  as  the  result  of  disease  or  injury.  It  may  become  excessive 
from  irritability  of  the  organ  from  which  the  centripetal  impulse 
starts,  or  of  the  reflex  centre  in  the  spinal  cord,  or  of  the  muscle 
or  other  organ  to  which  the  centrifugal  impulse  is  directed,  or 


6  Veterinary  Medicine, 

finally,  from  impairment  of,  or  separation  from  the  inhibitory 
centre  in  the  cerebrum.  It  may  be  impaired  or  abolished  from 
degeneration  or  destruction  of  any  of  the  tissues  just  named,  or 
of  the  conducting  nerves  which  connect  them  to  each  other. 

The  contraction  and  closure  of  the  pupil  under  light  is  a  reflex 
act  from  the  retina  on  the  optic  lobes,  etc.,  and  from  these 
through  the  motor  oculi  to  the  iris.  This  reflex  is  lost  and  the 
iris  fails  to  contract  in  :  anaesthesia  of  the  retina  ;  atrophy  of  the 
optic  nerve  ;  disease  of  the  optic  lobe ;  superior  (posterior)  spinal 
sclerosis  ;  disease  of  the  motor  oculi ;  or  disease  of  the  iris. 

The  lumbar  reflex  is  lost  in  many  febrile  states  in  the  horse,  so 
that  pinching  of  the  loins  fails  to  produce  wincing,  and  this  be- 
comes a  test  of  the  active  persistence  of  the  disorder. 

Increased  Reflex  is  often  noticed  when  the  parts,  including 
the  spinal  reflex  centre,  are  disconnected  from  the  brain  :  as  in 
lesions  or  disease  of  the  cord  in  front  (cephalad)  of  its  reflex  cen- 
tre.    Here  the  cerebral  or  voluntary  inhibition  is  lost. 

Reflex  Tonic  Spasm  of  muscles  around  a  diseased  or  dislo- 
cated joint,  or  of  those  controlling  its  action,  often  affords  a  val- 
uable means  of  diagnosis,  the  possibility  of  nervous,  muscular 
and  tendinous  disease  being  excluded. 


TROPHIC  SYMPTOMS  AND  DISORDERS. 

Degenerative  atrophy,  in  hsempglobinuria,  laryngeal  hemiplegia,  neurec- 
tomy, nerve  lesion,  brain  or  cord  lesion,  lead  poisoning,  disuse.  Dermatitis, 
ulceration,  morbid  secretion,  polyuria,  mellituria,  albuminuria,  poisonous 
mUk.- 

Degenerative  Atrophy.  From  section,  disease,  atrophy  or 
degeneration  of  nerves  or  nerve  centres,  the  muscles,  which  they 
normally  innervate,  waste,  often  to  an  extreme  degree.  As  ex- 
amples of  this  we  see  the  atrophy  of  the  triceps  extensor  cruris 
and  other  groups  in  hsemoglobinuria,  of  the  intrinsic  laryngeal 
muscles  in  roaring,  of  the  muscles  supplied  in  neurectomy,  and  of 
groups  of  muscles  in  myelitis,  broken  back,  lead  paralysis,  and 
scapular  muscular  atrophy.  True  to  the  law  of  wasting  of  physi- 
ologically inert  organs,  the  nerves  are  atrophied  and  degenerated, 
and  often  also  the  bones,  joints  and  skin. 


Trophic  Symptoms  and  Disorders,  7 

The  degeneration  of  an  inactiveorganapplies  to  the  nervous  tis- 
sues themselves.  According  to  the  law  of  Waller,  the  nerve  fibre 
(axis  cylinder),  when  cut  ofiF  from  its  nutritive  center  (cell  body 
with  nucleus)  degenerates  and  ultimately  perishes.  The  axis 
cylinder  is  a  component  part  of  the  neurou,  which  includes  also 
its  continuation  in  the  cell  and  nucleus,  and  when  the  latter, 
which  is  the  source  and  origin  of  both  nerve  impulse  and  trophic 
control,  is  lost,  the  inactive  axis  of  the  nerve  fibre  degenerates. 
This  law  is  now  availed  of  in  tracing  the  distribution  of  nerve  fila- 
ments, the  degeneration  being  found  in  those  that  have  been  cut 
ofiF  from  their  nerve  cells  while  those  that  come  into  the  nerve 
trunk  from  other  sources,  distal  of  the  injury,  maintain  their 
integrity. 

In  addition  to  this  peripheral  atrophy,  a  degeneration  centrad 
of  the  injury  to  the  nerve  is  seen  under  certain  conditions,  but 
especially  in  intrauterine  life.  In  such  cases  the  atrophy  may  ex- 
tend up  to  and  include  the  central  nerve  cells,  causing  a  secondary 
central  nervous  lesion  from  an  initial  peripheral  one. 

By  bearing  these  laws  of  nerve  atrophy  in  mind,  lesions  that 
would  otherwise  be  obscure,  may  be  satisfactorily  accounted  for. 

Eruptions  and  Ulcerations  of  a  Nervous  Origin.  Herpes 
or  shingles  in  man  is  now  recognized  as  a  nervous  disease,  cir- 
cumscribed to  the  distribution  of  given  nerves  and  occurring 
unilaterally  or  bilaterally.  Deep-seated  dermatitis,  vesicles,  neu- 
ralgia, pain,  itching  and  formication  are  common  accompaniments. 
The  whole  is  traced  to  disease  of  the  ganglion  on  the  posterior 
(superior)  root  of  the  spinal  nerve  distributed  to  the  part.  This 
establishes  a  principle,  and  in  inscrutable  and  obstinate,  circum- 
scribed skin  disease  the  veterinarian  should  see  if  it  coincides 
with  the  distribution  of  one  or  more  sensory  spinal  nerves. 

Ulcerations  are  often  caused  by  the  lack  of  protection  of  a  part 
after  paralysis,  thus  perforation  of  the  cornea  will  follow  section 
or  disease  of  the  trigeminus.  These  may  be  prevented  by  care- 
fully covering  the  part,  and  even  cured  by  a  fine  protective  cover- 
ing like  collodion. 

Alterations  of  the  Secretions  often  follow  on  section  of  the 
sympathetic  trunks,  that  of  the  cervical  sympathetic  in  rabbits 
causing  elccessive  congestion  of  the  facial  skin,  with  exudation 
and  scabby  product,  also  profuse  secretion  of  sweat,  tears,  and  ear 
cerumen  and  dry,  scaly  skin. 


8  Veterinary  Medicine, 

Polyuria  is  determined  by  section  of  one  point  of  the  medulla 
behind  the  root  of  the  vagus,  mellituria  by  puncture  between  the 
vagus  and  auditory  nerves  (the  hepatic  vaso-motor  centre),  and 
albuminuria  by  a  puncture  in  front  of  the  latter.  Impairment  of 
the  hepatic  vaso-motor  tracts  in  the  spinal  cord,  or  of  the  anterior 
or  posterior  cervical  sympathetic  ganglia,  or  of  the  first  thoracic 
ganglion  equally  determines  nervous  mellituria. 

Poisonous  milk  produced  in  hard  worked  mares,  or  over-ex- 
cited dams  of  other  species,  causing  dyspepsia,  diarrhoea,  arthritis 
or  other  trouble  in  the  suckling,  must  be  in  part  attributed  to 
nervous  disorder. 

Practically  all  secretions  and  nutrition  are  largely  under  nerv- 
ous control,  so  that  modifications  in  quantity  or  quality  can  often 
be  attributed  to  nervous  influence. 


SENSORY  SYMPTOMS  AND  DISORDERS. 

Hjperaesthesia,  cutaneous,  thermic,  muscular,  visceral.  Parsestbesia, 
pressure  on  nerve.     Anaesthesia,  partial,  drug.    Analgesia.     Hyperalgesia. 

These  are  necessarily  much  less  obvious  to  the  veterinarian 
than  to  the  physician  of  man.  Yet  in  certain  cases  they  may  be 
observed  directly,  and  in  others  deduced  from  dependent  symp- 
toms. 

Hypersesthesia  is  a  .state  of  exalted  excitability  of  any  part  of 
the  sensory  nervous  apparatus. 

Cutaneous  hypersesthesia  is  that  condition  in  which  the 
slightest  touch  gives  rise  to  an  instant  and  extreme  response. 
Some  nervously  organized  mares  which  are  dangerously  ticklish 
and  irritable,  afford  physiological  examples.  The  surface  sore- 
ness and  sensitiveness  which  exist  in  the  febrile  chill,  in  wounds, 
dermatitis  and  neuralgia  give  pathological  examples.  It  is  further 
seen  in  certain  cases  of  meningitis  (cerebral  and  spinal),  spinal 
irritations,  rabies,  tetanus  and  neuritis. 

Hypersesthesia  in  cold  is  seen  in  neuralgia,  rheumatism,  the 
early  stages  of  many  fevers  (chill),  in  myelitis,  neuritis,  nerve 
injuries,  and  in  posterior  (superior)  spinal  sclerosis. 

Hypersesthesia  of  the  muscles  may  be  noted  in  tetanus, 
muscular  rheumatism  and  neuralgia. 


Sensory  Symptoms  and  Disorders,  9 

Visceral  hyperesthesia  io  shown  in  many  cases  of  spasms  of  in- 
voluntary muscles  (colic,  arrest  of  intestinal  calculi,  gall  stones  or 
urinary  concretions),  and  in  inflammation  of  serous  membranes 
(pleurisy,  peritonitis). 

Parsesthesia.  This  is  a  painful  or  morbid  sensation  caused 
by  a  lesion  in  the  central  nervous  structures  or  in  the  nerves,  but 
referred  by  the  sufferer  to  some  peripheral  organ  oyer  which  such 
centre  presides.  It  may  even  be  referred  to  an  organ  or  part  that 
has  been  amputated  or  otherwise  removed.  This  may  cause  lame- 
ness of  a  kind  to  indicate  suffering  in  a  given  muscle,  tendon  or 
joint,  when  the  cause  is  purely  central.  In  dourine,  sexual  acts 
are  excited  which  have  their  real  source  in  the  nerve  centres. 
The  rabid  dog  snaps  at  imaginary  flies  in  mid- winter,  when  such 
insects  are  only  phantoms  of  his  brain. 

Pressure  on  a  nerve  trunk  induces  sensations  of  tingling, 
vibration,  formication,  heat,  cold,  and  paresis,  referred  by  the 
mind  to  the  part  to  which  that  nerve  is  distributed,  and  when  the 
pressure  is  removed  these  sensations  recede  in  the  order  in  which 
they  came.     This  may  explain  some  occult  cases  of  lameness. 

Itching  may  be  a  pure,  persistent  neurosis  without  any  skin 
lesion.  Treatment  should  then  be  addressed  to  the  nervous  sys- 
tem. 

Anaesthesia,  or  absence  of  sensation,  is  in  its  degree  partial  or 
complete.  The  latter  is  familiar  as  occurring  in  parts  the  sensory 
ner\'es  of  which  have  been  cut  across,  also  in  parts  the  sensory 
nerve  or  nerve  centres  of  which  have  become  completely  degene- 
rated. There  is  no  response  to  the  prick  of  a  needle,  the  touch 
of  a  hot  wire,  to  pinching  or  cutting.  If  the  nerve  remains  intact 
as  far  as  the  spinal  centres,  reflex  action  may  still  occur,  but  the 
patient  himself  has  no  consciousness  of  this  nor  of  the  injury 
causing  it.  Accordingly,  he  makes  no  movement  of  head,  ears, 
eyes,  or  other  parts  still  dominated  by  the  brain. 

In  partial  or  imperfect  anaesthesia,  the  response  to  irritation 
is  less  marked  and  may  be  even  delayed.  In  some  forms  of  cen- 
tral lesions  the  response  to  a  prick  may  be  delayed  two,  five,  or 
ten  seconds,  or  even  more. 

Anasthesia  causes  awkwardness  or  uncertainty  of  movement, 
especially  if  the  subject  is  blindfolded. 

Anaesthesia  may  be  induced  by  medicine,  as  in  the  general 


lo  Veterinary  Medicine, 

anaesthesia  of  etherisation,  or  the  local  anaesthesia  caused  by  the 
topical  applicatton  of  cocaine  or  carbolic  acid. 

Analgesia,  or  insensibility  to  pain,  may  be  present  in  cases  in 
which  ordinary  sensations  are  still  felt.  It  may  be  caused  by  co- 
caine, alcohol,  and  to  some  extent  by  carbolic  acid. 

Hyperalgesia  is  the  opposite  of  this  condition,  and  may  be 
seen  in  certain  irritable  conditions  of  the  nerve  centres. 


PSYCHIC  SYMPTOMS  AND  DISORDERS. 

Limitation  in  lower  animals.  Effects  of  age,  training,  race  heredity,  in- 
dividual and  racial  peculiarities,  exhaustion,  prostration,  dementia,  cerebral 
congestion,  compression,  degeneration,  narcotics,  ptomaines,  toxins.  Con- 
trolling absorption  in  another  trouble.  Delusions,  hallucinations,  vice, 
violence,  oestrum,  fatigue.    Cerebral  source  of  motions. 

These  have  a  much  more  restricted  field  in  the  lower  animals 
than  in  man  in  keeping  with  the  limitation  of  the  mental  facul- 
ties, and  they  may  often  be  traced  to  demonstrated  structural  dis- 
order. Yet  some  emotions  of  joy,  fear  or  rage  run  very  high 
and  are  comparatively  unchecked  by  high  mental  development  or 
mental  training.  The  effect  of  training  is,  however,  very 
marked  in  the  more  educated  animals. 

Age  modifies  by  the  sobering  that  come  from  experience  and 
habit.  The  frolics  of  puppies,  kittens,  lambs,  foals  and  calves 
are  in  marked  contrast  with  the  sedateness  and  stolidity  of  old 
dogs,  cats,  sheep  or  cattle. 

Training  is  seen  in  the  educated  horse  which  would  have 
been  panic  stricken  at  sight  of  a  locomotive,  flag  or  floating 
paper,  at  the  smell  of  a  lion  or  bear,  at  the  sound  of  a  gun  or 
drum,  and  which  will  now  boldly  face  any  one  of  these  with  no 
manifest  tremor.  The  emotional  puppy  can  be  trained  to 
soberly  fetch  and  carry,  to  drive  sheep  or  cattle  without  biting, 
to  lie  sentinel  by  his  master's  property,  to  point  at  birds  without 
seeking  to  catch  them,  or  to  carry  shot  birds  without  devouring 
them. 

Race  heredity  comes  from  the  training  along  the  same  lines 
in  many  successive  generations.  Thus  the  more  domesticated 
breeds  of  dogs  (shepherd,  poodle,  and  greyhound)  are  very  af- 


Psychic  Symptoms  and  Disorders.  1 1 

fectionate  ;  other  breeds  (bull,  mastifiF,  bloodhound)  are  lacking 
in  this  character.  AH  trained  races  take  naturally  to  the  occu- 
pations of  their  ancestors.  Some  (horses,  cattle  and  sheep)  are 
easily  panic-stricken,  (stampeded).  Some  (turkeys,  roosters) 
are  not  easily  stampeded.  Some  (skunks),  having  effective 
sources  of  defense,  have  little  fear  of  man. 

Individual  and  racial  mental  dullness  and  torpor  must 
also  be  recognized.  Some  are  stupid  and  slow,  others  alert  and 
quickly  responsive.  Some  horses  are  not  level-headed  and  be- 
come uncontrollable  in  difficult  situations.  Some  dogs  are  so 
emotional  as  to  endanger  their  lives  from  sudden  heart  trouble. 
Some  horses,  dogs  and  cats  will  pine  and  die  when  separated 
from  their  fellows  or  human  friends.  Extreme  timidity,  or 
sudden  rage  may  be  so  marked  as  to  constitute  a  virtual  morbid 
phenomenon.  Sluggish  cerebral  and  mental  action  may  result 
from  exhaustion^  prostration^  or  dementia  ;  also  from  cerebral  con- 
gestion, pressure  and  degeneration  ;  or  from  poisoning  by  nar- 
cotics y  ptomaines  or  toxins  (opium,  hyoscyamus,  Indian  hemp, 
dourine,  milk  sickness,  etc.  It  may  come  from  profound  ab- 
sorption in  another  object,  as  when  the  rabid  dog  bears  whipping 
without  a  howl. 

Delusions  or  hallucinations  are  shown  in  the  rabid  dog 
snapping  at  flies,  or  attacking  his  friend  or  master  as  an  enemy, 
as  well  as  in  other  forms  of  delirium.  Narcotics,  such  as  opium, 
Indian  hemp,  etc.,  ptomaines,  toxins,  and  (in  dogs)  essential 
oils  cause  delirium  by  acting  on  the  nerve  centres. 

Vice  in  its  various  forms  may  become  a  genuine  neurosis,  the 
animal  losing  control  of  its  actions. 

Violence  in  the  form  of  self-defense  or  aggression  is  seen  in 
mares  in  heat,  in  bulls  or  stallions  under  sexual  excitement,  in 
animals  roused  by  inconsiderate  whipping,  or  in  bulls  looking  on 
scarlet  clothing. 

Some  high-spirited  animals,  under  extreme  fatigue  from  over- 
work, sometimes  become  violent  but  resume  their  docility  under 
rest  and  food. 

In  all  cases  we  must  know  the  normal  of  an  individual  animal 
to  enable  us  to  properly  appreciate  any  apparent  deviation  from 
the  psychic  form.  No  less  essential  is  it  to  take  into  account 
the  environment  and  treatment  of  the  patient. 


1 2  Veterinary  Medicine. 

With  regard  to  localization  of  cerebral  lesions,  Sequin  thinks 
emotions  are  probably  generated  in  the  basal  ganglia  such  as 
those  of  the  pons  and  thalami,  while  inhibition  depends  on  the 
anterior  cerebral  cortical  convolutions. 


DIAGNOSIS,    SYMPTOMS    AND    THEIR    IMMEDIATE 

CAUSES.     LOCALIZATION  OF  LESION  IN 

SPECIAL  SYMPTOMS. 

Spasm,  pain,  numbness — irritation.  Paresis,  paralysis,  anesthesia  (con- 
stant), destructive  lesions.  Both  combined — variable  symptoms,  recurrent. 
Definite,  fixed  symptoms — structural  lesions,  usually  progressive.  Symp- 
toms, variable  as  to  place,  time,  subsidence  and  recurrence — functional 
lesions.  Brain  lesions.  Pressure  on  brain — pain,  spasm,  nausea,  dullness, 
blindness,  stupor,  coma,  palsy.  Congestion  and  ansmia  synchronous. 
Lesions  of  cortex.  Encephalic  lesions — hemiplegia,  with  spasms,  increased 
reflexes,  spasms  follow  cranial  nerves,  vertigo,  apoplexy,  epilepsy,  dementia, 
coma,  little  muscular  atrophy,  or  dermal  sloughing.  Spinal  lesions,  para- 
plegia, without  spasm,  reflex  reduced  or  nil,  follow  spinal  nerves,  head 
symptoms  less,  much  muscular  atrophy,  bed  sores.  Sensory  and  motor 
tracts,  in  cms  cerebri,  respiratory  centres — inspiratory,  expiratory,  inhibi- 
tion. Salivation,  sneezing,  coughing,  sucking,  chewing,  swallomng,  vomit- 
ing. Cardiac  centres,  accelerating  and  inhibitory.  Vasomotor  centre. 
Spasm  centre.  Perspiratory  centre.  Pons.  Corpora  quadrigemini,  crura 
cerebri.  Thalamus,  corpus  striatum.  Cerebellum.  Cerebral  cortex  :  in 
ass  ;  in  dog.  Spinal  lesions  :  lateral  half  section  :  central  anteroposterior, 
vertical  section  :  superior  columns  ;  inferior  columns ;  cervical  lateral 
columns  ;  respiratory  tract ;  glycogenic  centre ;  pupillary  dilator ;  cardiac 
accelerator  ;  vaso  motor,  sudoriparous  ;  centre  for  anal  sphincter ;  for  vesi- . 
cal  sphincter  ;  genital  cCntre  ;  vaso-motor  and  trophic  centres ;  muscular 
sense  tract ;  superior  column  and  Goll's.  Table  of  phenomena  from  cord 
lesions. 

In  Irritation  of  nervous  organs  the  symptoms  (spasm,  pain, 
numbness)  are  usually  intermittent. 

In  Destructive  Lesions  of  nervous  organs  the  symptoms, 
(paresis,  paralysis,  anaesthesia)  are  usually  constant. 

When  irritation  and  destruction  are  associated  the  symp- 
toms are  variable  and  frequent.  The  characteristic  symptoms  of 
the  two  may  coexist  or  succeed  each  other. 

Structural  Nervous  Lesions  have  symptoms  that  are  definite 


Localization  of  Lesion  in  Special  Symptoms,  13 

in  their  area  of  distribution,  nature,  (spasm,  paralysis)  and  per- 
manency. Objective  Symptoms  predominate  and  the  case  is  likely 
to  be  progressive  and  fatal. 

Functional  Nervous  Diseases  have  symptoms  of  indefinite 
distribution,  variable  in  character,  with  intermissions  and  spon- 
taneous disappearances  (as  under  marked  excitement)  and  sub- 
jective sjrmptoms  predomin£ite.  They  may,  however,  last  for  a 
length  of  time  without  change. 

Localization  of  Brain  Lesions. 

Lesions  of  the  cranial  nerves  and  their  superficial  and  deep 
centres  of  origin  need  not  here  occupy  attention.  These  may  be 
studied  in  works  on  anatomy  and  physiology.  Attention  may  be 
drawn  rather  to  the  remoter  effects  of  ganglia  which  effect  or 
control  distant  action,  and  to  general  pressure  on  the  encephalon. 

General  Pressure  on  the  Encephalon,  whether  through 
fracture  of  the  cranium  and  depression  of  bone,  by  acute  conges- 
tion, by  blood  extravasation,  by  inflammatory  exudation,  or  by 
acute  abscess,  will  cause  pain,  spasms,  nausea,  dullness,  blind- 
ness, stupor  and  coma.  After  expulsion  of  the  cerebrospinal 
fluid  from  cranial  cavity,  the  increasing  pressure  compresses 
the  blood  vessels,  reduces  or  interrupts  the  circulation  and 
abolishes  the  functions  in  the  parts  deprived  of  blood.  Thus 
congestion  of  one  portion  of  the  encephalon  is  usually  associated 
with  diminished  circulation  in  another  portion.  Disorder  in  the 
first  may  occur  from  h3rperaemia  and  irritation  and  in  another 
part  from  a  consequent  anaemia. 

Destructive  Lesions  of  Cortex  of  One  Cerebral  Hemi- 
sphere may  or  may  not  cause  permanent  symptoms,  as  shown 
by  the  passage  of  a  crowbar  through  the  front  of  the  left  hemi- 
sphere, yet  the  man  survived  for  13  years  and  showed  no  loss  of 
intelligence,  his  disposition  and  character  alone  having  changed 
for  the  worse.  The  one  hemisphere  may  by  itself  suflSciently 
control  mental  acts,  while  the  other  lies  dormant  or  may  even 
have  undergone  degeneration. 

Diagnosis  of  Encephalic  and  Spinal  Lesions.  The  fol- 
lowing may  be  taken  as  guiding  principles  : 

Encephalic  :  Hemiplegic  or  bilaterally  hemiplegic  grouping 
of  sjonptoms. 


14  Veterinary  Medicine, 

Spinal :     Paraplegic  grouping  of  symptoms. 

Encephalic :  Frequent  contracture  or  spasms  of  paretic 
muscles. 

Spinal :     Paralysis  more  perfect  and  continuous. 

Encephalic  :  Reflexes  in  afiFected  muscles  increased  :  Cerebral 
inhibition  absent. 

Spinal :  Reflex  abolished  or  reduced  in  parts  the  seat  of  the 
lesion. 

Encephalic :  Spasms  in  areas  of  distribution  of  cranial  nerves 
(not  spinal. ) 

Spinal :  Spasms  and  paralysis  follow  distribution  of  spinal 
nerves. 

Encephalic :  Head  symptoms  frequent  (vertigo,  apoplexy, 
epilepsy,  dementia,  coma). 

Spinal :     Relative  absence  of  head  symptoms. 

Encephalic :  Comparative  absence  of  marked  muscle  atrophy. 

Spinal :     Atrophy  in  special  muscular  groups. 

Encephalic  :     Little  tendency  to  form  bed  sores. 

Spinal :    Tendency  to  form  sloughs  and  bed  sores. 

Sensory  (^sthesodic)  and  Motor  (Kinesodic)  Tracts  in 

Encephalon. 

In  the  cms  and  above,  the  sensory  tract  lies  dorso-laterad  of  the 
motor  tract,  forming  about  one-fifth  of  the  cms,  and  extending 
upward  through  a  white  layer  bending  inward  to  form  an  angle 
and  finally  diverging  to  the  different  cortical  convolutions.  The 
motor  tract  is  mainly  contained  in  the  inferior  pyramids  of  the 
bulb,  and  constitutes  the  median  two  fifths  and  basal  two  fifths  of 
the  cms.  Without  entering  farther  into  this  subject  it  will  be 
observed  that  lesions  of  the  outer  layer  of  the  cms  and  its  radi- 
ating fibres  may  cause  hemiansesthesia  of  body  or  head,  includ- 
ing the  eye,  while  lesions  of  the  median  and  basal  layers  and 
radiating  fibres  induce  hemiplegia  of  the  head,  tongue,  fore 
limb,  hind  limb,  trunk,  etc. 

Respiratory  Centres,  Inspiratory  and  Expiratory  are  in 
the  floor  of  the  fourth  ventricle  between  the  centres  for  the  vagus 
and  accessory  nerves,  and  are  directly  stimulated  by  the  CO,  in 
the  blood.  Secondary  subsidiary  centres  are  in  the  optic  thala- 
mus, in  the  corpora  quadrigemini  both  anterior  and  posterior 


Sensory  and  Motor  Tracts  in  EncephaUm.  15 

pairs,  and  finally  in  the  cervical  spinal  cord,  so  that  disorder  of 
respiration  may  occur  from  lesions  in  these  points  as  well  as  in 
the  main  oblongata  centre. 

Respiratory  Inhibition  and  arrest  depend  on  the  vagus,  the 
superior  and  inferior  laryngeal  nerves. 

The  Salivation  Centre  also  lies  in  the  floor  of  the  fourth 
ventricle  and  stimulation  of  the  medulla  causes  free  secretion. 

The  Centres  for  Sneezing,  Coughing,  Sucking,  Chewing, 
Swallowing  and  Vomiting  are  also  seated  in  the  oblongata,  so 
that  any  one  of  these  phenomena  may  come  from  a  central  irrita- 
tion. In  bulbar  paralysis  the  loss  of  power  usually  extends  from 
the  tongue  through  the  lips,  cheeks,  jaws,  pharynx,  larynx,  to 
the  respiratory  muscles  and  heart.  Coughing  may  be  roused  by 
irritation  of  the  external  auditory  meatus,  liver,  stomach,  bowels, 
or  generative  organs  as  well  as  from  the  air  passages. 

Cardiac  Accelerating  and  Inhibiting  Centres  are  both 
present  in  the  bulb,  the  latter  receiving  its  afferent  impulse  main- 
ly through  the  vagus  nerve.  Stimulation  of  the  vagi,  anaemia  of 
the  bulb  through  decapitation  or  through  tying  both  carotids, 
h3rperaemia  through  tying  of  the  jugulars,  a  venous  state  of  the 
blood,  and  blows  on  the  abdomen  all  slow  or  arrest  the  heart 
action.  Digitalis  or  muscarin  has  a  similar  effect.  The  heart 
action  is  accelerated  by  febrile  and  inflammatory  affections,  by 
a  high  or  low  temperature  by  section  of  the  vagi,  by  sipping 
of  cold  water,  by  atropine  or  curari,  and  by  salts  of  soda.  Potash 
salts  on  the  other  hand  restore  the  inhibitory  action  of  the  vagi 
and  lower  the  heart's  action. 

The  Vaso  Motor  Centre  is  also  in  the  oblongata  and  the 
contraction  of  the  vessels  with  increase  of  arterial  pressure  may 
ensue  from  afferent  currents  in  the  sympathetic  nerve  and  many 
sensory  trunks.  The  varying  activity  is  seen  in  blushing,  in  the 
congestion  of  mucous  membranes  under  rage  or  excitement,  in  the 
capillary  contraction  in  the  early  stage  of  inflammation,  in  the 
second  stage  of  capillary  dilation,  in  angioma,  or  nsevus,  and  in 
extensive  congestions  and  haemorrhages  in  different  organs.  The 
arrest  of  bleeding  under  fainting  is  due  largely  to  the  anaemia  of 
this  centre. 

A  Spasm  Centre^the  pricking  of  which  causes  general  con- 
vulsions lies  in  the  medulla:  oblongata  at  its  junction  with   the 


1 6  Veterinary  Medicine. 

pons.  This  is  excited  by  excess  of  carbon  dioxide  in  the  blood, 
by  sufiFocation,  drowning,  by  anaemia  of  the  bulb  from  bleeding 
or  ligature  of  the  carotids,  by  venous  congestion  after  ligature  of 
the  jugulars,  or  by  the  direct  application  to  the  part  of  ammonia 
carbonate,  or  salts  of  potash  or  soda.  It  may  also  be  aroused  by 
afferent  nervous  currents  from  different  peripheral  parts  (spinal 
cord,  sciatic  nerve,  etc.). 

A  Perspiratory  Centre  is  found  in  the  medulla,  on  each  side, 
which  may  be  roused  into  action  by  diaphoretics  (opium,  ipeca- 
cuan,  tartar  emetic,  Calabar  bean,  nicotin,  picrotoxin,  camphor, 
pilocarpin,  ammonia  acetate,  etc.). 

The  Pons  like  the  medulla  is  at  once  a  ganglionic  and  con- 
ducting organ,  and  its  lesions  may  lead  to  arrest  of  nerve  currents 
generated  above  or  below  it,  or  to  the  failure  to  develop  currents 
in  its  own  centres.  Stimulation  of  its  superficial  layers  may  be 
without  effect,  but  if  this  is  carried  into  the  centre  epileptiform 
convulsions  ensue.  Lesions  of  one  side  of  its  posterior  half  cause 
facial  paralysis  the  same  side  and  motor  and  sensory  paralysis  on 
the  opposite  side  of  the  body  (crossed  hemiplegia).  Lesions  of  one 
side  of  its  anterior  half  cause  paralysis  in  both  face  and  body  on 
the  same  side.  This  depends  on  the  crossing  of  the  fibres  mid- 
way back  in  the  pons,  which  cross  again  in  the  medulla  (motor 
fibres)  and  in  the  spinal  cord  (sensory  fibres).  Lesions  of  the 
pons  are  liable  to  interfere  with  the  functions  of  the  trigemini, 
the  oculo  motor  and  the  superior  oplique,  and  to  determine 
epileptic  movements  and  loss  of  coordination  of  sensorio-motor 
movements.  Lesions  of  the  superficial  transverse  fibres  (median 
cerebellar  peduncles)  tend  to  cause  involuntary  movements  to 
one  side. 

Lesions  of  the  Corpora  Quadrigemina  cause  disturbance  of 
vision,  failure  of  the  pupil  to  contract  to  light,  blindness,  paralysis 
of  the  oculo-motor  nerves,  and  lack  of  coordination  of  move- 
ments. Stimulation  of  one  anterior  corpus  causes  rolling  of 
both  eyes  to  the  opposite  side,  with,  if  continued,  a  similar  move- 
ment of  the  head  and  even  of  the  body  (horse  in  mill,  or  index 
motion,  or  rolling  on  its  axis). 

The  Crura  Cerebri  are  conducting  bodies  but  contain  also 
different  nerve  centres.  Lesions  of  one  cms  cause  violent  pain 
and  spasm  on  the  opposite  side  of  the  body,  followed  by  paralysis. 


Sensory  and  Motor  Tracts  in  Encephalon,  17 

The  oculo  motor  moy  be  paralyzed  on  the  same  side,  but  the  face 
and  tongue  on  the  opposite  side,  owing  to  the  fibres  crossing  in 
the  pons.     There  may  be  turning  movements. 

The  Optic  Thalamus  transmits  sensory  currents  to  the  cere- 
bral cortex.  Lesions  in  this  organ  cause  sensory  paral>*sis  on  the 
opposite  side  o£  the  body.  Afferent  currents  that  do  not  traverse 
the  thalamus  cause  reflexes  only.  It  contains  one  of  the  roots  of 
the  optic  nerve  and  its  destruction  will  impair  vision.  Its  in- 
juries may  also  produce  turning  movements. 

The  Corpus  Striatum  transmits  motor  currents  originating 
in  the  cerebral  cortex.  Lesions  of  its  interior  (lenticular  nucleus) 
cause  motor  paral3rsis  and  sometimes  anaesthesia  on  the  opposite 
side  of  the  body.  Electrical  stimulation  of  this  nucleus  causes 
general  muscular  contractions  of  the  opposite  side  of  the  body. 
Irritation  of  the  surface  layers  is  painless  and  s^rmptomless. 

The  Cerebellum  has  been  long  credited  with  coordination, 
andPlourens,  after  its  removal  from  a  pigeon,  found  an  utter  lack 
of  harmonized  movement  in  walking,  springing  or  balancing, 
Ludani  removed  the  organ  from  a  bitch  and,  after  full  healing  of 
the  part,  found  a  lack  of  muscular  tone  (a  cerebellar  ataxy),  so 
that  no  great  muscular  effort  could  be  satisfactorily  accomplished. 
After  months,  marasmus  set  in  and  proved  fatal.  The  lack  of 
coordination  is  especially  connected  with  lesionsof  the  vermiform 
process,  those  of  the  posterior  portion  causing  falling  forward  and 
those  of  the  anterior  portion,  falling  backward.  Injury  to  the 
middle  peduncle  on  one  side  causes  turning  or  rolling  to  the 
opposite  side.  Under  slighter  injuries  they  may  be  only  un- 
steadiness and  staggering  like  a  drunken  man.  Nausea  and 
vomiting,  with  more  or  less  stiffness  of  the  neck  or  oposthotonos, 
may  be  present.     Rolling  of  the  eyes  or  squinting  may  occur. 

Focal  Cortical  Centers  of  the  Cerebrum.  Cortical 
Localization.  Much  has  been  done  experimentally  and  by 
observation  of  morbid  lesions  to  locate  functions  in  the  different 
convolutions,  and  though  the  subsidiary  implication  of  adjacent 
and  interdependent  parts  interferes  with  a  perfectly  confident 
diagnosis,  yet  certain  fundamental  facts  may  be  borne  in  mind  as 
contributing  to  a  satisfactory  diagnosis. 

Arloing,  on  the  basis  of  his  own  experiments  and  those  of  his 


1 8  Veterinary  Medicine. 

predecessors,  gives  the  following  as  applicable  to  the  equine  (ass) 
brain : 

1.  Stimulation  of  the  origin  of  the  front  part  of  the  first  frontal 
convolution,  or  of  the  anterior  part  of  the  pre-Sylvian  convolu- 
tion, causes  approximation  of  the  feet  on  the  opposite  side  of  the 
body. 

2.  Stimulation  of  the  superior  part  of  the  first  frontal  convolu- 
tion or  of  the  superior  part  of  the  post-Rolandic  convolution 
causes  closure  of  the  jaws  and  diduction. 

3.  Stimulation  of  the  anterior  end  of  th£  upper  orbital  convo- 
lution, or  of  the  anterior  part  of  the  pre-Rolandic  convolution, 
leads  to  movements  of  the  nose  and  upper  lip. 

4.  Stimulation  of  the  antero-superior  part  of  the  lower  frontal 
convolution,  or  the  union  of  the  post-Rolandic  with  the  Sylvian 
convolution  causes  movement  of  tongue  and  jaws. 

5.  Stimulation  of  the  union  of  the  vertical  and  horizontal  parts 
of  the  orbital  convolution  or  frontal  lobe,  causes  opening  of  the 
jaws  and  bending  of  head  and  neck. 

6.  Stimulation  in  the  front  of  the  union  of  the  frontal  and 
longitudinal  convolutions,  or  at  the  union  of  the  Sylvian  and  sec- 
ond parietal  convolution  causes  rolling  of  the  opposite  eye. 

7.  Stimulation  of  union  of  the  frontal  and  parietal  parts  of  sec- 
ond parietal  convolution  leads  to  closure  of  both  eyelids  or,  with 
a  strong  current,  of  lids  on  both  sides. 

8.  Stimulation  of  the  second  parietal  convolution,  above  and  a 
little  behind  the  extremity  of  the  Sylvian  fissure,  causes  opening 
of  the  eye  and  adduction  of  the  ear  on  the  opposite  side,  or,  if  a 
very  strong  current,  on  both  sides. 

9.  Strong  stimulation  of  the  posterior  part  of  the  first  and  sec- 
ond parietal  convolutions  causes  tonic  convulsions. 

ID.  Currents  through  the  posterior  parts  of  the  third  and  fourth 
parietal  convolutions  give  similar  convulsions  with  violent  trem- 
bling of  the  trunk  and  members. 

In  the  Dog's  Brain  localization  is  easily  made  by  reference  to 
the  crucial  fissure  which  passes  outward,  right  and  left,  at  right 
angles  with  the  longitudinal  fissure  about  the  junction  of  its 
anterior  with  its  middle  third.  Also  by  four  parietal  convolutions 
which  run  backward  from  near  the  crucial  fissure,  parallel  with  the 
longitudinal  fissure.     They  are  counted  from  without  inward. 


Sensory  and  Motor  Tracts  in  Encephalon,  19 

Fritsch,  Hitzig  and  Ferrier  have  mapped  out  the  following  motor 
areas : 

1 .  The  convolution  in  front  of  the  outer  end  of  the  crucial  sul- 
cus controls  the  muscles  of  the  neck. 

2.  The  bend  of  the  same  convolution  backward,  opposite  the 
outer  extremity  of  the  crucial  sulcus,  controls  the  extensors  and 
adductors  of  the  fore  limb. 

3.  The  convolution  just  behind  the  outer  end  of  the  crucial 
sulcus  controls  the  muscles  which  flex  and  rotate  the  fore  limb. 

4.  The  same  convolution  behind  the  middle  of  the  crucial  fis- 
ure  controls  the  movements  of  the  hind  limb. 

5.  The  second  convolution  back  of  the  crucial  fissure  controls 
the  muscles  of  the  face. 

6.  The  anterior  part  of  the  internal  (4th)  parietal  convolution, 
just  back  of  the  crucial  fissure,  controls  the  lateral  switching 
movements  of  the  tail. 

7.  The  posterior  angle  of  the  first  post-crucial  convolution 
causes  retraction  and  abduction  of  the  fore  limb. 

8.  The  outer  end  of  the  first  post-crucial  convolution,  directly 
behind  the  outer  end  of  the  sulcus,  causes  raising  of  the  shoulder 
and  extension  of  the  fore  limb. 

9.  The  anterior  end  of  the  third  parietal  convolution  (the 
second  from  the  longitudinal  fissure)  controls  closure  of  the  eye- 
lids, the  rolling  of  the  eyeball  upward,  and  narrowing  of  the 
pupil. 

10.  Stimulation  of  the  anterior  end  of  the  second  parietal  con- 
volution causes  partial  opening  of  the  mouth  with  retraction  and 
elevation  of  its  angle. 

11.  Stimulation  of  the  point  of  union  of  the  first  and  second 
parietal  convolutions  anteriorly  causes  opening  of  the  mouth 
with  protrusion  and  retraction  of  the  tongue. 

12.  Stimulation  of  the  median  part  of  the  second  parietal  con- 
volution, causes  retraction  and  elevation  of  the  angle  of  the  mouth. 

13.  Stimulation  of  the  convolution  directly  in  front  of  the 
outer  end  of  the  crucial  sulcus  causes  dilatation  of  the  eyelids 
and  pupil  while  the  eyes  and  head  are  turned  toward  the  oppo- 
site side. 

14.  Stimulation  of  the  convolution  behind  the  crucial  fissure 
causes  contraction  of  the  muscles  of  the  perineum. 


20  Veterinary  Medicine. 

15.  Stimulation  of  the  convolution  in  front  of  the  crucial  fis- 
sure, on  its  anterior  and  sloping  portion,  causes  movements  of 
the  pharynx  and  larynx  (swallowing). 

16.  Stimulation  of  motor  areas  of  the  cortex,  by  scraping,  irri- 
tation, or  disease  tends  to  produce  spasmodic  contractions  of  cer- 
tain groups  of  muscles  (Jacksonian  Epilepsy).  Strong  stimula- 
tion may  cause  general  epileptiform  spasms,  which  are  at  first 
tonic,  then  clonic.  One  such  seizure  strongly  predisposes  to  a 
second.  If,  during  an  attack,  the  cortical  centres  presiding  over 
a  special  group  of  muscles  were  sliced  off,  such  muscles  relaxed, 
though  tlie  general  spasms  in  the  other  muscles  continued. 

Lrocalizations  of  Spinal  Lesions. 

Being  at  once  a  conductor  between  the  brain  and  nerves,  and  a 
reflex  nerve  centre,  we  must  consider  both  roles  in  seeking  to 
locate  lesions  from  sjrmptoms.  In  passing  from  the  nerves  to 
and  from  the  sensorium  both  sensory  and  motor  currents  cross  so 
that  one  side  of  the  brain  presides  over  the  other  side  of  trunk 
and  limbs.  This  crossing  of  the  motor  fibres  takes  place  in  the 
medulla  oblongata,  while  that  of  the  sensory  fibres  occurs  in  the 
spinal  cord  close  in  front  of  the  nerve  from  which  they  have 
entered. 

Cross-Section  of  one  lateral  half  of  the  spinal  cord 
therefore  causes  motor  paralysis  and  rise  of  temperature  of  the 
whole  of  that  side  of  the  body  posterior  to  the  lesion,  while  it  in- 
duces sensory  paralysis  and  cooling  on  the  opposite  side  of  the 
body  up  to  the  same  point,  A  very  limited  sensory  paralysis  on 
the  same  side  occurs  corresponding  to  the  few  sensory  fibres  pass- 
ing outward  obliquely  through  the  portion  injured  by  the  cross- 
section. 

A  vertical  section  of  the  cord  separating  the  one  lateral 
half  from  the  other  does  not  necessarily  affect  the  motor  cur- 
rents, while  it  produces  a  limited  anaesthesia  on  each  side  in  the 
area  of  distribution  of  the  nerves,  the  sensory  fibres  of  which 
crossed  in  the  seat  of  the  lesion. 

Transverse  section  of  the  superior  columns  causes  hyper- 
sesthesia  and  lack  of  coordination. 

Transverse  section  of  inferior  columns,  or  of  the  in- 
ferior horn  of  gray  matter,  if  close  behind  the  medulla,  causes  no 


Locaiizaiicm  of  Spinmi  Ltsioms.  at 

motor  paral3rsis,  but  if  farther  back  induces  motor  pand>*sis  on 
the  same  side  of  the  body. 

Transverse  section  of  the  cervical  lateral  columns  causes 
motor  paralysis  of  the  lateral  walls  of  the  chest  (respiratory 
tract).  If  the  section  is  mad^  in  the  dorsal  or  lumbar  region  it 
is  the  same  as  lesion  of  the  superior  columns. 

Among  reflex  centres  in  the  cord  the  following  may  be  named  : 

The  Respiratory  Tract  in  the  cervical  lateral  columns  just 
referred  to. 

A  Glycogenic  Centre  in  the  anterior  cervical  section  be- 
tween the  bulb  and  the  fourth  cervical  nerve. 

Centres  vrhich  Dilate  the  Pupil  between  the  fifth  cervical 
and  the  sixth  dorsal  nerve. 

Cardiac  Accelerator  Centres  between  the  three  last  cer\*ical 
and  the  five  first  dorsal  nerves. 

Vaso-Motor  Sudoriparous  Centres  in  the  central  gray 
matter. 

Centre  for  Anal  Sphincter  between  the  sixth  and  seventh 
dorsal  nerves. 

Centre  for  Vesical  Sphincter  between  the  third  and  fifth 
lumbar  nerves. 

Genital  Centre,  opposite  the  first  lumbar  nerve. 

Vaso-motor  and  Trophic  Centres  are  found  in  the  inferior 
horns  of  gray  matter,  and  their  degeneration  causes  progressive 
muscular  atrophy. 

The  Muscular  Sense  Tract  is  located  near  the  surface  of 
the  superior  columns,  so  that  a  certain  amount  of  incoordination 
and  unsteadiness  of  progression  follows  its  destruction. 

The  Deeper  Part  of  the  Superior  Columns  and  the  Column 
of  GoU  which  bounds  the  superior  median  fissure  control  mus- 
cular sense  and  coordination,  and  their  disease  (posterior  lateral 
sclerosis)  entails  locomotor  ataxy. 


22 


Veterinary  Medicine. 


TABLE  SHOWING  PROMINENT  PHENOMENA  PROM  LESIONS 
OF  THE  CORD. 


LB8XON8  IN 


Cervical  Rcaion. 


Doraal  Region 


LumtMir  Region 


paralysis  in 
Sensation 

Atrophy   . 
Blectric  reaction 

Bladder 


Bowels 

Superficial  reflex 
Deep  reflex 
Priapism 


Neck     muscles  ;    d  i  a 

phragm;     trunk 

limbs. 
Local  hypenesthesia  in 

fore  limbs.    Aneesthe- 

sia  in   rest  of   limbs 

and  trunk. 
Rare  in  neck ;  common 

in  fore  legs. 
Lessened  in  atrophied 

muscles. 


Retention  or  intermit- 
tent incontinence  re- 
flex, or  (later)  from 
overflow  Cystitis 
common. 

Involuntary  evacuation 
(reflex  spasm)  or  con- 
stipation. 

Temporary  loss  ;  then 
rapid  increase. 

Temporary  loss  ;  then 
slow  increase. 

Often  present 


Dorsal,abdominal  and 
intercostal  muscles. 
Paraplegia. 

HyperKStnesiain  low- 
er part  of  abdominal 
walT 

Slight  in  muscles  be- 
hind lesion. 

Lessened  in  dorsal 
and  abdominal  mus- 
cles ;  slightly  in 
wasted  leg. 

Same  as  cervical. 


Same  as  cervical. 

Same  as  cervical. 
Same  as  cervical. 
Often  present. 


Paraplegia. 


Hyperaesthesia  in 
zone  around  loins  : 
aneesthesia  in  hind 
limbs. 

In  hind  limbs. 

Lessened  in  atrophied 
muscles ;  in  ratio. 


Incontinence     f  r  om 
palsy  of  sphincter. 


Paralysis  of  sphincter 
with  incontinence  ; 
costiveness. 

Lost. 

Lost. 
Absent. 


k 


HALLUCINATIONS. 


Subjective   cerebral   impressions   projected   as   real. 
Poisons.     Essential  oils.    Chloroform. 


Rabies.    Toxins. 


Hallucinations  are  subjective  impressions  which  the  animal 
supposes  to  be  real.  The  disorders  in  his  brain  are  projected  out- 
ward and  become  to  him  real  objects  and  occurrences. 

They  may  arise  from  the  presence  of  proliferation  of  microbes 
in  the  brain  as  in  rabies  in  animals.  They  may  proceed  from  poi- 
soning of  the  brain  by  toxins  as  in  anthrax. 

They  may  be  developed,  in  dogs  especially,  by  the  action  of  cer- 
tain essential  oils  on  the  cerebral  cortex.  The  first  two  classes 
will  be  considered  with  those  special  diseases.  The  mental  dis- 
orders from  drugs  have  been  studied  experimentally  by  Cadeac 
and  Mennier,  and  may  be  noticed  in  this  place. 


Timidity.     Panic.     Stampede.  23 

Lavander,  fennel  and  angelica  produce  in  the  dog  a  condition 
of  extreme  terror,  and  overcome  all  disposition  to  exercise  self- 
defense. 

Mints  and  origanum  induce  hallucinations  of  odor.  The  dog 
seeks  around  with  head  and  nose  elevated,  sniffs  the  air,  moves 
cautiously,  fixes  his  eye  on  some  phantom  object,  and  starts  to 
hunt  imaginary  game.  The  love  of  catmint  seems  to  amount  to  a 
mania  in  the  feline  animal. 

Kidney  vetch  evidently  causes  a  sensation  of  itching  or  formi- 
cation ;  the  dog  bites  the  hair  of  the  tail,  the  hind  limbs  or  the 
flank  as  if  to  destroy  fleas  or  other  vermin. 

Dogs  under  chloroform  have  sought  to  hunt,  and  stallions  un- 
der ether  have  shown  generative  excitement  with  erection  of  the 
penis  and  movements  of  coition. 


TIMIDITY.     PANIC.     STAMPEDE. 

Timidity.  Panic.  Timid  driver.  Impaired  vision.  Nervous.  Irritability. 
Gaddiofr.  Gregariona  habit.  Absence  of  natural  weapons.  Treatment. 
Habit  Snbstitiition.  Absolute  constraint  Kindness.  Boldness.  Work. 
Moderate  diet 

An  animal  is  naturally  nervous,  and  by  habit  has  become  timid 
until  it  is  virtually  impossible  to  utilize  it.  In  a  body  of  animals, 
fear  is  quickly  transferred  from  one  to  the  other  until  all  join  in 
a  wild  panic  and  stampede.  This  is  common  in  range  cattle  or 
horses,  but  is  found  in  army  horses  as  well,  and  a  whole  regiment 
will  sometimes  refuse  to  longer  face  the  enemy  and  flee  in  spite  of 
every  effort  of  the  rider.  On  a  smaller  scale,  two  timid  horses  in 
a  team,  scared  by  some  unusual  sight,  add  each  to  the  sense  of 
fear  of  the  other,  as  they  try  to  escape,  until  they  gallop  blindly 
into  any  danger.  This  sense  of  terror  is  often  fostered  by  the 
timid  rider  or  driver,  every  feeling  of  apprehension  conveyed 
through  the  trembling  or  tmcertain  hand,  or  the  voice  which  has 
lost  the  element  of  confidence,  tending  to  undermine  the  last  ves- 
tige of^trust  on  the  part  of  the  horse.  Imperfect  sight  is  one 
cause  of  panic,  as  the  perception  of  common  objects  in  distorted 


24  Veterinary  Medicine, 

form  or  unwonted  situations  strikes  terror  to  the  timid  animal, 
causing  shying  or  bolting.  Better  absolute  blindness  than  such 
imperfect  vision. 

A  constitutional  timidity  tends  constantly  to  increase  unless  the 
animal  is  judiciously  accustomed  to  the  object  of  terror.  The 
horse  once  scared,  seems  to  become  more  and  more  watchful  for 
other  objects  of  dread,  and  even  inclined  to  bolt  from  such  as  are 
common  and  of  every  day  occurrence. 

Cattle  and  sheep  attacked  by  the  gadfly  (oestrus)  flee  in  great 
terror,  and  this  dread  is  communicated  from  animal  to  animal  so 
that  the  whole  herd  or  flock  is  suddenly  panic-stricken.  The  bel- 
low of  the  ox  attacked  and  the  erection  of  its  tail  is  the  signal  for 
every  other  within  reach  to  join  the  stampede. 

These  panics  are  associated  with  the  instinct  of  these  races  to- 
ward a  gregarious  life ;  they  mass  together  for  protection  and 
they  learn  to  heed  the  slightest  indication  of  approaching  danger. 
This  instinct  grows  more  powerful  by  constant  exercise,  and  is 
most  marked  in  those  genera  which  have  the  least  natural  means 
of  protection.  Hence,  of  all  animals  sheep  are  most  easily  panic- 
stricken,  and  once  affected,  they  move  in  mass,  one  following  its 
fellow,  without  object,  without  definite  direction  or  destination, 
and  without  consideration  of  the  other  dangers  they  are  to  meet. 
Hence,  if  one  sheep  jumps  over  the  parapet  of  a  bridge  to  certain 
destruction,  the  whole  flock  speedily  follows.  If  one  leaps  over  a 
fallen  tree  into  a  snow  bank,  all  at  once  follow  suit  and  pile  above 
each  other  in  one  suffocating,  perishing  mass. 

While  this  condition  is  hereditary  in  gregarious  families,  it  is 
essentially  a  psychosis  in  those  animals  that  have  been  often 
scared  until  they  are  continually  on  the  watch  foi  objects  of  fear. 
Treatment.  In  the  case  of  horses,  the  best  course  is  to  make 
the  animal  familiar  with  the  object  of  dread  ;  let  him  look  at  it, 
approach  it  siowly,  smell  it,  feel  it  with  his  lips.  Never  turn 
away  his  eyes  from  it  and  drive  him  off,  as  that  confirms  the  im- 
pression of  dread,  and  the  object  retains  ever  after  its  dreaded 
appearance.  In  this  way  timid  colts  become  gradually  fearless  of 
umbrellas,  city  sights,  street  cars,  large  vans,  flags,  music,  loco- 
motives and  the  like, — they  become,  in  the  expressive  language  of 
the  horseman,  road-wise,  A  paddock  or  yard  beside  a  railroad 
will'soon  accustom  a  timid  horse  to  the  cars,  and  so  with  other 
things,  experience  will  remove  apprehension. 


Timidity,     Panic,     Stampede,  25 

A  more  speedy  reilioval  of  the  habit  of  dread  may  often  be 
secured  by  the  principle  of  substitution.  The  mind  of  the  animal 
does  not  readily  attend  to  more  than  one  matter  at  a  time  ;  if, 
therefore,  we  can  distract  the  attention  in  another  direction,  the 
object  of  fear  may  be  virtually  ignored  until  the  eye  has  become 
habituated  to  it,  and  it  will  be  recognized  as  harmless.  Thus  it  is 
that  a  twitch  on  the  upper  or  lower  lip,  a  binding  of  the  chin  in 
upon  the  breast  by  a  Yankee  bridle  may  make  the  horse  tempo- 
rarily heedless  of  the  object  of  terror.  So  also  in  the  bolting 
horse,  the  obstruction  of  the  breath  by  a  cord  with  a  running 
noose  around  the  neck,  or  the  sending  of  an  electric  current 
through  wire  reins  and  bit  will  promptly  check  him  in  his  wild 
career. 

The  result  is  still  better  when  the  animal  is  made  to  feel  his 
utter  helplessness  in  the  hands  of  man  and  the  futility  of  any  at- 
tempt to  escape.  On  this  are  based  the  method  of  Rarey  and  of 
his  various  successors.  With  fore  limbs  strapped  up,  the  animal 
soon  exhausts  himself  in  his  efforts  to  disengage  them  and  escape, 
and  lies  down  completely  reconciled  to  his  fate.  He  may  now  be 
accustomed  to  his  objects  of  terror — the  opening  and  closing  of 
an  umbrella,  or  the  waving  of  a  flag  over  his  head,  the  discharge 
of  a  gun  close  to  his  ear,  the  passing  of  car  or  locomotive,  or  any 
other  object  of  his  dread.  When  allowed  to  get  up  he  will  usu- 
ally pay  no  further  attention  to  these  things,  especially  if  patted 
and  spoken  to  encouragingly,  and  perhaps  fed  apple  or  sugar,  or 
something  of  which  he  is  fond.  As  far  as  is  consistent  with  the 
thoroughness  of  the  subjection,  the  animal  should  be  treated 
throughout  with  the  greatest  kindness,  so  as  to  retain  and  even 
increase  his  trust  in  man  and  sense  of  dependence,  while  at  the 
same  time  he  is  strongly  impressed  with  the  futility  of  resistance 
to  his  will.  After  the  animal  has  been  thus  taught  to  bear  with 
equanimity  his  former  objects  of  terror,  he  should  not  be  at  once 
allowed  to  forget  them,  but  by  daily  experience  he  should  be  con- 
firmed in  the  conviction  that  they  are  harmless,  and  may  be  met 
with  safety.  This  should  be  carried  out,  if  possible,  in  the  hands 
of  the  bold  and  kind  operator  who  has  trained  him,  as,  if  returned 
to  a  timid  driver  or  rider,  he  may  be  easily  lead  back  into  his  for- 
mer habits  of  blind  terror.  A  similar  and  even  easier  resort  is  the 
process  of  turning  as  given  under  balking. 


26  Veterinary  Medicine. 

Constant  hard  work,  for  a  time,  is  an  excellent  form  of  acces- 
sory treatment,  as  the  plethora  developed  by  over-feeding  and 
temporary  idleness  begets  an  irritability  and  impatience  of  control 
which  is  quite  likely  to  beguile  him  into  his  old  habits. 

In  case  of  runaway,  beside  the  electric  and  asphyxiating  treat- 
ment already  referred  to,  the  animal  may  be  blinded  and  quickly 
brought  to  a  stand-still.  Movable  blinds  may  be  used  which 
habitually  stand  well  out  from  the  eyes,  but  which  may  be  instant- 
ly drawn  closely  over  them  by  the  simple  pulling  of  a  cord.  The 
sudden  darkness  and  the  impossibility  of  directing  his  course, 
brings  an  instant  realization  of  the  existence  of  other  dangers  be- 
side the  original  bugbear. 


BALKING.     RESTIVENESS. 

Definition.  Common  in  asd  and  mule.  Causes :  low  condition  ;  overload- 
ing ;  nervousness ;  sluggish  nature ;  irritable  driver ;  shbnlder  sores  ;  poor 
collar ;  hard  bit :  sharp  or  sore  maxilla  ;  sores  in  angle  of  mouth  ;  mares  ; 
racial  tendency :  going  from  stable  :  a  psychosis.  Symptoms  :  stands  stock 
still ;  plunges,  but  won't  draw ;  will  stamp,  bite,  kick,  rear,  buck,  crowd  on 
wall :  lie  down.  Breach  of  warranty ;  sound  price ;  willfulness ;  balking  of 
raw  horse  ;  diagnosis  from  nervous  disorders  ;  sores,  etc.  Time  in  which  re- 
turnable. Treatment :  preventive,  curative ;  distract  attention  ;  cord  on  ear  : 
whiff  of  ammonia  or  capsicum  ;  closing  nostrils  ;  blindfolding  ;  tying  up  the 
fore  leg ;  stroking  nose,  eyes  or  ears ;  tapping  flexors  or  metacarpus ;  move 
in  circle  with  head  tied  to  tail ;  coax  to  go. 

In  general  terms  this  has  been  defined  as  a  refusal  to  obey. 
Usually  in  solipedsit  is  a  refusal  to  move  as  directed  with  a  load, 
under  the  saddle,  or  in  hand.  Though  essentially  a  vice,  it  may 
become  such  a  fixed  habit  that  it  appears  to  dominate  the  will  of 
the  animal  and  may  thus  be  called  a  psychosis — a  mental  infirm- 
ity. 

It  is  much  more  common  in  asses  and  mules  than  in  horses,  in 
keeping  with  their  more  obstinate  disposition  and  too  often 
harsher  treatment. 

There  may  be  simple  refusal  to  pull.  This  often  comes  from 
overloading,  and  especially  when  the  animal  has  been  sick  or 
idle,  and  comes  back  to  work  with  soft  flabby  muscles  unequal  to 


Balking,     Restiveness,  27 

any  violent  exertion.  After  one  or  two  ineffective  efforts  he  sets 
himself  back  in  the  harness  refusing  to  try  again  and  the  vice  is 
started.  Ordinary  loads  on  bad  roads  full  of  holes  from  which  it 
is  impossible  to  drag  the  wheels  have  a  similar  effect.  The  dan- 
ger is  greater  if  the  animal  is  naturally  of  a  nervous  or  impatient 
disposition,  and  if  he  makes  a  desperate  plunge  forward  and  fails 
at  once  to  move  the  load.  Such  a  horse  hitched  with  a  slow 
steady  mate  is  liable  to  have  expended  his  effort  before  the  latter 
has  had  time  to  join  him  in  the  pull,  and  it  becomes  impossible  to 
move  the  load  because  the  two  cannot  be  started  simultaneously. 
The  conditions  are  aggravated  if  the  driver  is  irritable  and  by 
voice  and  acts  further  excites  the  already  too  excitable  animal. 

Lesions  of  various  kinds,  such  as  shoulder  bruises,  abscesses, 
abrasions  and  callouses,  saddle  bruises,  callouses,  abscesses  or  fist- 
ulae  cause  acute  pain  whenever  the  effort  is  made,  and  render  the 
animal  more  impatient  and  indisposed  to  try  again. 

Too  small  a  collar  or  one  that  fits  badly  (too  narrow,  uneven) 
has  often  a  similar  effect. 

Among  other  causes  may  be  named  a  hard  bit  harshly  used,  a 
sharp  edge  of  the  lower  jaw  bone  where  the  bit  rests  in  the  inter- 
dental space,  sores  of  the  buccal  mucous  membrane  in  this  situ- 
ation, and  caries  or  necrosis  of  the  superficial  layer  of  the  bone. 
Also  chaps,  ulcers,  or  cancroid  of  the  angle  of  the  mouth. 

Young  horses,  that  are  as  yet  imperfectly  trained,  are  more 
readily  driven  to  balk  than  old  trained  animals. 

Mares  are  more  subject  to  the  vice  than  geldings,  by  reason 
apparently  of  a  more  nervous  disposition,  but  much  more  because 
of  the  excitement  to  which  they  are  subjected,  under  the  periodic 
returns  of  heat. 

Peuch  speaks  of  rare  hereditary  cases  in  which  the  habit  is 
uncontrollable  and  the  animal  incurable. 

Friedberger  and  Frohner  accuse  chestilut  and  sorrel  horses  as 
being  especially  liable  to  balk. 

However  started  the  continued  exercise  of  the  act  fixes  it 
as  an  incurable  habit  a  virtual  psychosis.  Yet  the  inclination 
of  the  animal,  his  likes  and  dislikes  to  a  certain  extent  con- 
trol its  manifestations,  thus  a  horse  rarely  balks  in  going  home, 
and  shows  it  mostly  in  going  in  the  opposite  direction,  and 
above  all  on  a  new  or  unknown  road. 


28  Veterinary  Medicine, 

The  Symptoms  vary  greatly  in  difiFerent  cases.  One  animal 
stands  stock-still  propping  his  legs  outward  and  absolutely  re- 
fusing to  budge.  This  may  occur  even  in  the  stall  when  it  is 
attempted  to  take  the  animal  out.  When  on  the  road  he  is 
usually  willing  to  turn  and  go  back,  but  no  persuasion  by  voice 
or  whip  can  force  him  forward. 

Other  horses  make  ineflFective  plunges  forward  but  never  throw 
weight  enough  into  the  collar  to  overcome  any  resistance. 

Still  others  stamp,  bite,  throw  themselves  to  one  side  rather 
than  forward,  rear  up,  strike  with  the  fore  feet,  and  if  whipped 
kick  with  the  hind.  Some  will  throw  themselves  down  and 
struggle  in  this  condition. 

Under  the  saddle  the  animal  may  crowd  against  a  wall,  rear, 
kick,  buck  or  even  throw  himself  down  in  his  efforts  to  dis- 
lodge the  rider.  These  violent  manifestations  however  rather 
belong  to  vice  than  mere  balking.  Trembling,  perspiration, 
frequent  rejection  of  urine,  and  general  acceleration  of  pulse 
and  breathing  may  manifest  a  severe  nervous  disorder. 

Diagnosis,  It  is  often  important  to  pronounce  upon  the  exact 
nature  of  this  trouble  so  as  to  determine  whether  the  seller  is 
responsible  for  a  breach  of  warranty  given  or  implied.  As  regards 
implied  warranty  a  sound  price  for  au  animal  sold  to  do  a  given 
kind  of  work  implies  a  mutual  understanding  that  the  animal  is 
not  physically  or  psychically  incapacitated  for  such  work. 

The  balking  horse  is  one  that  obstinately  refuses  to  perform 
a  piece  of  work  for  which  his  physical  condition  seems  to  be  well 
adapted.  The  willfulness  of  the  refusal  is  the  important  feature. 
In  case  of  such  a  serious  drawback  to  the  value  of  a  horse,  the 
presumption  of  fraud  on  the  part  of  the  seller  is  unavoidable,  in 
case  he  failed  to  mention  the  habit  to  the  purchaser,  but  of  course 
this  is  even  more  emphatically  certified  if  he  has  warranted  the 
animal  as  a  good  worker;  or  kind^  or  true  in  work. 

On  the  other  hand  he  cannot  be  held  responsible  for  the  fail- 
ure to  perform  an  act  in  case  the  horse  has  been  overloaded  when 
fat  or  out  of  condition,  or  if  he  has  sores  on  back,  withers  or 
shoulders,  a  badly  fitting  collar,  a  severe  or  large  clumsy  bit,  or 
sores  on  the  lower  jaw,  or  indeed  any  temporary  physical  in- 
firmity, to  which  the  balking  can  be  fairly  attributed. 

Balking  is  not   to    be    confounded    with   nervous  affections 


Balking^  Resttveness,  29 

(paretic,  spasmodic,  congestion)  in  which  the  failure  to  obey  is 
not  due  to  lack  of  will,  but  to  lack  of  power.  Nor  must  it 
be  confounded  with  the  inability  of  the  paralysis  of  lead  pois* 
oning.  It  is  perhaps  most  likely  to  be  confounded  with  that 
lack  of  both  sensory  and  motor  power  which  attends  on  ven- 
tricular dropsy  and  other  chronic  affections  of  the  brain.  In  such 
cases  (immobility,  coma)  the  habitual  dullness,  drowsiness,  gen- 
eral hebetude,  and  lack  of  energy  contrasts  strongly,  with  the 
strength,  vigor  and  general  life  of  the  animal  which  suddenly, 
willfully  and  incorrigibly  balks. 

The  balky  horse  which  has  no  such  nervous  disorder  as  an  ex- 
cuse, no  badly  fitting  harness,  no  lesion  on  shoulder,  back,  limbs 
nor  mouth,  no  unsuitable  bit,  no  special  softness  nor  poverty  of 
condition,  no  slow,  ill-adjusted  mate,  no  impatient  driver,  and  no 
excessive  load,  nor  impassable  road,  but  which  jibs  without  ex- 
cuse, as  a  willful  disobedience,  may  well  be  cause  for  annulling 
a  sale.  In  most  European  countries  such  a  horse  can  be  returned 
to  the  seller  and  the  sale  set  aside  within  3  dajrs  (Austria),  4 
days  (Prussia),  5  days  (Saxony),  9  days  (Hesse). 

Treatment,  This  should  be  preventive  by  avoiding  the 
various  causes  above  enumerated,  for  if  the  habit  is  once  con- 
tracted it  is  too  often  impossible  to  establish  a  permanent  cure. 
The  horse  is  largely  a  bundle  of  habits  and  the  first  act  of  dis- 
obedience has  given  a  bias  to  the  nerve  cells  of  the  cortex  cerebri 
which  like  a  planted  seed  tends  to  reproduce  itself  whenever  an 
opportunity  offers.  With  ever>'^  successive  act  of  the  kind,  the 
impression  on  the  nerve  cells  becomes  deeper  and  more  indelible 
and  the  habit  fixed  the  more  firmly. 

In  slight  recent  cases  in  the  milder  dispositions  the  vice  may 
be  overcome  by  some  resort  which  engages  and  engrosses  the 
animal's  attention.  Among  these  may  be  named  t3dng  a  cord 
round  the  root  of  the  ear  and  tying  it  down  ;  giving  an  inhala- 
tion of  ammonia  or  a  sniff  of  powdered  capsicum  ;  closing  the 
nostrils  until  the  horse  struggles  to  breathe  ;  blindfolding  for  a 
few  minutes  ;  t)ang  up  one  fore  leg  until  thoroughly  tired  ;  even 
stroking  the  nose  or  ears  until  the  fret  is  overcome.  Immedi- 
ately following  on  any  one  of  these  methods,  move  the  horse 
gently  to  the  right  and  left  and  call  him  confidently  to  get  up. 
Some  will  start  if  gently  tapped  with  the  toe  below  the  knee 


30  Veterinary  Medicine. 

until  the  foot  is  lifted  and  repeating  this  a  few  times  in  succes- 
sion, then,  after  a  few  steps,  reward  with  an  apple,  sugar  or 
piece  of  bread,  and  don't  push  too  far  at  a  time  but  repeat  the 
lesson  often.  If  among  the  first  exhibitions  of  the  vice  it 
may  be  met  by  occupying  the  time  in  a  make-believe  fixing  of 
the  harness  until  the  animal  ceases  to  fret,  then  standing  by  his 
head,  tap  him  on  the  croup  with  a  whip  and  call  him  to  go  on. 
Or  he  may  first  be  moved  to  the  right  and  left  and  then  ordered 
to  move.  A  rather  wearisome  treatment  is  to  place  in  the  stall 
with  a  man  behind  him  who  taps  him  on  the  rump  every  few 
minutes,  preventing  composure,  rest,  or  sleep,  and  keeping  this 
up  without  interval  for  twenty-four  hours  or  even  double  that 
time  if  necessary.  If  he  goes  well  when  hitched,  he  is  driven 
but  if  he  balks,  he  is  returned  to  the  stall  and  the  treatment  con- 
tinued. 

Magner,  who  mentions  all  these  methods,  reserves  his  highest 
commendation  for  the  method  of  tjdng  the  horse's  head  round  to 
his  tail  and  letting  him  turn  in  a  circle  until  he  is  giddy  and  falls 
over.  Some  stubborn  cases  get  habituated  to  turning  in  one 
direction  and  continue  obdurate  until  the  head  and  tail  are  tied 
around  on  the  other  side  and  the  rotary  motion  reversed. 
When  thoroughly  dazed  by  this  treatment,  the  animal  is  hitched 
up  and  will  usually  move  on.  If  there  is  still  an  indisposition, 
stand  by  his  head  and  tap  the  croup  with  a  whip,  calling  on  him 
to  start.     Or  subject  him  to  further  rotary  treatment. 


DELIRIUM. 


A  phenoDieiioii  in  different  morbid  states  ;  cerebrml  hypi  rsemia,  ansemia, 
congestion,  inflammation,  intoxication,  toxin  poisoning.  Symptoms  :  horse, 
ox,  sheep,  swine,  dog.  Treatment :  adapted  to  primary  disease  present, 
narcotic,  poison,  and  to  degree  of  violence.  Anaesthetics,  soporifics,  cerebral 
sedations,  cold  to  head,  eliminants,*  depletion  or  tonics  and  nutritious  food. 

Delirium  or  derangement  of  emotional  or  mental  functions  is 
usually  the  result  of  organic  disease  of  the  brain  and  especially  of 
the  cortical  gray  matter  of  the  cerebrum.  It  is  seen  in  hyperae- 
mia,  anaemia,  faults  of  nutrition,  intoxications  and  variations  of 


Delirium.  31 

temperature.  The  derangements  of  circulation  may  be  in  the 
meninges  or  in  the  nervous  substance.  ,The  intoxications  may 
be  with  mineral  (lead,  mercury),  vegetable  (opium,  Indian  hemp, 
belladonna,  hyoscyamus,  stramonium,  strychnia),  or  other 
poisons,  including  the  toxic  products  of  microbes  (as  in  pneu- 
monia, scalma,  rabies,  influenza,  Rinderpest,  milk  sickness, 
Texas  fever,  etc.). 

Symptoms,  These  are  usually  an  extraordinary  and  disorderly 
nervous  excitement.  Horses  take  expectant  or  ready  positions 
of  the  limbs,  plunge  with  feet  in  rack  or  manger,  rear,  turn,  kick, 
bite,  spring  violently,  neigh,  and  push  or  knock  the  head  against 
the  wall.  Cattle  bellow  in  a  loud  or  frightened  manner,  attempt 
to  kick  and  gore,  grind  the  teeth  and  make  movements  of  the 
jaws,  froth  at  the  mouth,  dash  themselves  in  any  direction  heed- 
less of  obstacles,  push  the  head  against  the  wall  breaking  teeth  or 
horns,  and  moving  heedlessly  against  fences,  or  trees,  or  into 
water  or  pits  even  to  their  own  destruction.  Sheep  stamp  the 
feet,  butt,  bleat,  work  the  jaws,  grind  the  teeth,  leap,  and  move  in 
a  given  direction  regardless  of  obstacles.  Pigs  grunt,  tremble, 
champ  the  jaws,  run  against  obstacles,  scratch  the  ground  with 
their  feet  or  snout  and  creep  under  the  litter.  They  may  even 
attempt  to  bite.  Dogs  are  restless,  whine,  move  in  a  circle,  snap 
at  straw,  bars,  doors,  and  other  objects,  and  may  show  a  disposi- 
tion to  bite.  In  all  the  domestic  animals  these  delirious  S3anp- 
toms  may  closely  resemble  those  of  rabies.  This  has  been  par- 
ticularly noticed  in  certain  forms  of  poisoning.  Pascault  has 
found  this  in  cattle  that  had  eaten  garlic  and  Cadeac  in  dogs  that 
had  eaten  tansy. 

The  animals  in  such  cases  become  morbid,  dull,  taciturn,  they 
become  usually  hypersensitive,  sometimes  hyposensitive,  have  a 
change  of  voice,  and  show  a  readiness  to  resent  and  bite  if  inter- 
fered with,  and  even  to  wander  away  by  themselves  as  in  rabies. 
On  the  other  hand  they  may  be  siezed  with  lethargy  and  torpor 
as  in  dumb  rabies,  and  with  or  without  access  of  convulsions  may 
pass  away  in  a  condition  of  paralysis. 

Among  other  conditions  these  symptoms  have  been  found  to  be 
associated  with  epilepsy,  foreign  bodies  in  the  pharynx,  gullet, 
stomach  or  bowels,  with  intestinal  parasites,  or  with  mycotic 
poisoning  (ergotism,  smut,  the  fungus  of  coniferous  trees,  etc.). 


32  Veterinary  Medicine, 

The  lack  of  the  extreme  hyperaesthesia  and  excitability  of 
rabies,  and  usually  of  the  mischievous  disposition  to  bite,  the 
presence  of  foreign  bodies  in  the  mouth  or  gullet,  and  the  evi- 
dence of  disorder  of  digestion,  with  costiveness,  tympany,  and 
tenderness,  and  the  history  of  the  case  may  serve  to  differentiate. 
In  cases  of  doubt  the  innoculation  of  a  rabbit  on  the  brain  should 
demonstrate  the  absence  of  rabies  by  the  absence  of  the  charac- 
teristic symptoms  after  sixteen  days. 

Treatment,  As  delirium  in  animals  is  a  deranged  innervation 
from  congestion,  narcotic  drugs,  ptomaines,  etc.,  it  must  be 
looked  on  as  in  most  cases  a  mere  phenomenon,  pointing  to  a 
definite  disease,  or  to  a  particular  intoxication,  and  treatment 
must  be  directed  toward  the  removal  of  the  primary  cause.  Thus 
the  remedial  measures  must  be  directed  in  the  different  cases  to 
the  encephalitis,  meningitis,  digestive  disorders,  contagious  dis- 
ease, or  drug  to  which  the  affection  may  be  traced.  The  patient 
must  be  put  in  a  strong  inclosure  or  securely  tied  so  that  he  can 
do  no  harm  :  it  will  often  be  desirable  to  secure  shade  or  cool  air, 
or  to  apply  cold  water  or  ice  to  the  head,  and  to  quiet  the  nervous 
excitement  by  inhalations  of  chloroform,  or  ether,  rectal  injec- 
tions of  chloral,  or  bromides,  or  full  doses  of  hyoscine,  sulphonal, 
trional  or  tetronal.  These  may  be  pushed  to  the  extent  of  induc- 
ting anaesthesia,  sleep  or  quiet,  as  the  case  may  be,  and  meanwhile 
other  measures  should  be  taken  to  eliminate  the  poisons,  correct 
the  congestion,  or  remove  the  source  of  irritation.  Anaemic 
oases  may  demand  iron  and  bitters,  with  an  aliment  rich  and 
easily  assimilated,  while  plethoric  cases  may  require  purgation, 
diuresis  or  even  bloodletting.  All  noise  and  any  cause  of  excite- 
ment must  be  carefully  guarded  against. 


VICIOUSNESS.    AGRESSIVE  VICE. 

Subject  malicioiuly  nsing  its  natural  weapons.  Horse  kicks,  bites,  crowds 
against  wall,  rears,  bucks,  plunges,  treads  upon.  Cattle  use  horns  or  fore- 
bead,  or  kick.  Dog  bites.  Cats  scratch  and  bite.  Ticklishness  different 
Developed  or  inherited.  Revenge.  Desperation  in  pain.  Sexual.  A 
psjrchosis.  Responsibility  of  owner,  in  selling,  toward  employe,  in  exposing 
in  a  public  place.  Treatment :  remove  source  of  suffering,  treat  kindly, 
secure  confidence,  castrate,  place  under  abfolute  constraint,  throw  a  la 
Rarey^  Comanche  bridle,  tie  head  to  tail  and  circle,  etc. 

This  word  is  employed  to  cover  only  those  forms  of  vice  in 
which  the  animal  shows  a  malignant  disposition  to  attack  or  in- 
jure man  or  beast.  Each  animal  uses  its  natural  weapons  accord- 
ing to  the  occasion. 

The  horse  strikes  with  his  fore  feet,  kicks  with  his  hind,  bites, 
crowds  his  rider's  legs  against  a  wall,  or  his  attendants*  body  against 
the  side  of  the  stall,  rears,  bucks,  plunges,  or  treads  his  victim 
tmder  his  feet. 

The  ruminants,  large  and  small,  use  their  horns,  and  cattle 
their  feet  as  well.  In  the  absence  of  horns  they  still  use  the  fore- 
head, but  much  less  effectively  and  usually  only  with  the  purpose 
of  defence. 

The  dog  attacks  with  his  teeth  and  the  cat  with  her  claws  by 
preference,  and  uses  the  teeth  as  a  secondary  weapon. 

Sv^ine  use  their  tusks  to  rip  or  disembowel  their  adversary  or 
victim. 

A  very  ticklish  horse  cannot  bear  to  be  touched  on  the  flank  or 
hind  parts,  without  throwing  the  ear  backward,  glancing  back, 
showing  the  white  of  the  eye,  and  lifting  the  foot.  But  if  this 
is  mere  excess  of  sensitiveness  and  begets  no  disposition  to  kick 
it  is  not  viciousne&s. 

The  vicious  horse  will  in  such  cases  bite  or  kick  repeatedly  and 
with  well  directed  purpose.  He  will  moreover  show  the  move- 
ments of  ears  and  eyes  and  attack  his  victim  in  the  absence  of 
any  such  excuse,  the  simple  approach  being  a  sufficient  occasion. 
He  will  bile  and  strike  with  the  fore  feet  at  the  same  time,  or  he 
may  strike  out  with  one  hind  foot  or  with  both  at  once.     He  may 

3  33 


34  Veterinary  Medicine, 

attack  indiscriminately  all  who  approach  him,  or  reserve  his  ill- 
will  for  particular  individuals,  and  then  he  often  acts  under  a 
feeling  of  revenge  for  ill-usage  from  this  individual  or  some  one 
he  conceives  him  to  represent. 

In  some  cases  viciousness  is  inherited  and  certain  families  have 
a  bad  reputation  in  this  respect.  It  may  be  either  a  survival  of 
the  ancestral  disposition  of  the  wild  horse,  or  it  may  be  a  trait 
developed  by  ill-usage  of  a  team  of  more  immediate  ancestors. 

In  other  cases  the  habit  is  acquired  by  the  individual  himself, 
and  in  such  cases  it  may  be  due  to  brutal  treatment  at  the  hands 
of  man ;  to  a  continuous  punishment  of  a  high-spirited  horse 
leading  to  resentment  and  retaliation ;  to  acute  pain  in  boils, 
abrasions  or  other  sores  in  the  root  of  the  mane,  or  the  shoulder, 
or  the  back,  where  pressed  on  by  the  collar  or  saddle.;  or  to  the 
generative  excitement  of  mares  in  heat.  In  many  such  cases  the 
vice  lasts  only  during  the  persistence  of  the  cause,  in  others  it 
becomes  permanent.  The  stallion  is  much  more  disposed  to 
aggressive  vice  than  the  gelding. 

Whether  we  may  consider  the  vice  a  disease  or  not,  it  becomes 
a  habit  engrained  in  the  nature,  the  nerve  centres  tending  to  re- 
produce their  habitual  acts  indefinitely,  so  that  we  may  look  on 
the  condition  as*  a  psychosis  which  is  too  often  incurable. 

Responsibility  of  the  ov^ner..  Dangerous  aggp-essive  vice  is 
too  self-evident  to  the  buyer  to  constitute  a  good  cause  for  an- 
nulling a  sale,  but  it  has  this  legal  bearing,  that  the  owner  who 
keeps  an  animal  known  to  be  vicious,  renders  himself  responsible 
for  whatever  injury  to  man  or  beast  he  may  perpetrate.  Thus 
the  vicious  stallion,  bull  or  dog  in  a  public  place  which  damages 
person  or  property,  renders  his  owner  liable  to  the  extent  of  such 
damages.  This,  of  course,  must  be  largely  qualified  by  the  at- 
tendant circumstances.  The  man  employed  to  take  care  of  a 
horse,  knows  his  babits  as  fully  as  the  owner,  takes  his  chances 
and  should  exercise  due  precautions  to  avoid  danger.  The  per- 
son who  enters  a  stall  carelessly  without  speaking  to  the  horse, 
seeing  that  he  stands  over,  or  otherwise  responds  to  his  call,  is 
himself  to  blame  if  he  gets  kicked.  The  attendant  who  does 
things  to  a  dangerous  or  questionable  horse  for  mere  bravado 
cannot  blame  the  owner  if  he  gets  himself  injured.  If  a  person 
teases  a  horse  so  as  to  tempt  him  to  retaliate,  not  only  is  he  re- 


Vtdousness,     Ag^essive   Vice.  35 

sponsible  for  his  own  consequent  injuries,  but  largely  also  for 
the  habits  of  the  horse  and  for  such  injuries  as  others  may  sub- 
sequently sustain  from  him. 

A  dog  or  a  bull  shown  in  a  public  place,  and  which  breaks 
loose  and  injures  spectators  or  others,  manifestly  renders  his 
master  responsible  for  all  such  damage. 

Treatment  of  aggressive  vice.  In  mild  dispositions  in  which 
the  vice  is  roused  by  temporary  suffering,  it  may  often  be  cured 
by  removal  of  the  cause  of  such  suffering.  Indeed,  without  the 
healing  of  sores  under  the  collar  or  saddle  the  vice  cannot  be  ar- 
rested. Considerate  and  gentle  treatment,  too,  will  go  far  to  re- 
store confidence  and  to  gradually  do  away  with  the  aggressive 
disposition. 

In  wicked  stallions  castration  will  usually  restore  to  a  good 
measure  of  docility.  The  exceptional  cases  appear  to  be  those 
that  are  hereditarily  and  constitutionally  vicious,  or  in  which  the 
habit  has  been  thoroughly  developed  and  firmly  fixed  by  long 
practice. 

Mares,  too,  which  become  vicious  and  dangerous  at  each  re- 
currence of  oestrum,  can  usually  be  completely  cured  by  the  re- 
moval of  the  ovaries  especially  if  this  is  done  early  in  the  disease. 

The  inveterate  cases  may  usually  be  subdued  and  rendered 
controllable  for  a  time  by  one  of  the  methods  of  subjugation  em- 
ployed by  the  professional  tamers,  but  unless  they  are  thereafter 
kept  in  good  hands  they  are  liable  to  relapse  into  the  old  habit. 
Among  the  more  effective  methods  are  the  Rarey  mode  of  throw- 
ing which  may  be  repeated  again  and  again  until  the  animal  is 
thoroughly  impressed  with  a  sense  of  the  domination  of  man  and 
the  futility  of  resistance  ;  the  resort  of  tying  the  head  and  tail 
closely  together  and  letting  the  animal  weary  and  daze  himself 
by  turning  in  a  circle,  first  to  one  side  and  then  to  the  other  ; 
the  application  of  the  Comanche  bridle  made  of  a  small  rope,  one 
loop  of  which  is  passed  through  the  mouth  and  back  of  the  ears 
and  drawn  tightly,  then  another  loop  is  made  to  encircle  the 
lower  jaw,  and  the  chin  is  drawn  in  against  the  trachea  by 
passing  the  free  end  of  the  rope  round  the  upper  part  of  the  neck 
and  again  through  the  loop  encircling  the  lower  jaw  and  draw- 
ing it  tight ;  or  a  similar  small  rope  is  passed  a  number  of  times 
through  the  mouth  and  back  of  the  ears  and  drawn  tightly  so  as 


36  Veterinary  Medicifie, 

to  compress  the  medulla  and  stupefy  the  animal.  This  is  supposed 
to  be  rendered  more  eflFective  by  passing  one  turn  each  between 
the  upper  lip  and  gums  and  between  the  lower  lip  and  the  gums. 


CATALEPSY. 


Definition.  Tetanic  and  paralytic  forms.  Balance  of  flexors  and  extensors 
Cataleptoid.  No  constant  lesion.  Hysterical.  Hypnotic.  Subjects  ;  horse,  ox, 
wolf,  cat,  chicken,  Gnineapig,  snake,  frog,  crayfish.  Causes :  strong  mental 
impression,  Indigestion,  etc,  in  susceptible  system.  Lesion  :  inconstant, 
muscular  degeneration,  etc.  Symptoms  :  wax  like  retention  of  position 
given,  voluntary  movement  in  abeyance,  mental  functions  impaired,  secre- 
tions altered.  Duration  and  frequency  variable.  Treatment :  shock  ;  cold  ; 
ammonia,  pepper,  snuff,  electricity,  amyle  nitrite,  nitro- glycerine,  apomor- 
phine,  bromides,  purgatives,  bitters,  iron,  zinc,  silver,  open  air  exercise. 

Definition,  This  is  a  functional  nervous  disorder,  characterized 
by  paroxysms  of  impaired  or  perverted  consciousness,  diminished 
sensibility,  and  above  all  a  condition  of  muscular  rigidity,  by 
means  of  which  the  whole  body,  or  it  may  be  but  one  or  more 
limbs  retain  any  position  in  which  they  may  be  placed. 

Laycock  describes  two  forms  in  man — the  catochus  or  tetanic 
form,  and  the  paralytic  form.  Mills  would  restrict  the  name  cat- 
alepsy to  cases  in  which  the  muscular  tone  is  such' that  the  affect- 
ed part  may  be  bent  or  moulded  like  wax  or  a  leaden  pipe,  and 
will  not  vary  from  this  when  left  alone.  Other  forms  in  which 
this  waxen  flexibility  (flexibilitas  cerea)  is  absent  or  imperfect 
he  would  designate  as  catalepoid. 

The  disease  is  not  associated  with  any  constant  cerebral  lesion, 
though  it  may  supervene  in  the  course  of  other  nervous  disorders, 
and  therefore  may  own  an  exciting  cause  in  existing  lesions  of 
the  brain.  The  immediate  cause  must  however  be  held  to  be 
functional,  and  this  is  in  keeping  with  its  most  common  form  in 
man  (hysterical),  and  with  the  hypnotic  form  which  is  observed 
both  in  man  and  animals.  This  latter  may  be  looked  on  as 
a  form  of  induced  or  hypnotic  sleep,  in  which  the  retention  of  the 
position  given  to  a  limb  or  part  is  the  most  prominent  symptom. 
In  all  cases  there  is  an  impaired  condition  of  the  sensory  func- 
tions of  the  cerebral  convolutions,  and  an  insusceptibility  of  the 
motor  centres  to  the  control  of  the  will,  or  the  reflex  stimulus. 


Catalepsy,  37 

Hering  has  recorded  the  disease  in  the  horse,  Landel  in  the  ox, 
and  Leisering  in  the  prairie  wolf.  The  hjrpnotic  form  has  been 
shown  in  cats,  chickens,  and  Guinea  pigs.  The  serpent  charm- 
ing of  the  Indian  dervishes  and  similar  effects  on  frogs  and  cray- 
fish have  been  attributed  to  hypnotic  catalepsy. 

Causes.  Strong  mental  emotions  and  diseases  which  pro- 
foundly affect  the  nervous  system  have  been  adduced  as  causes 
(fear,  excitement,  chills).  Indigestible  food  has  even  been 
charged  with  causing  it.  There  is  undoubtedly,  to  begin  with 
a  specially  susceptible  nervous  system,  and  hence  it  is  liable  to 
prove  hereditary,  and  in  man  to  appear  as  a  form  of  hysteria,  or 
to  alternate  in  the  same  family  with  epilepsy,  chorea,  alcoholism, 
opium  addiction  and  other  neurosis. 

Hypnotism  as  a  cause  is  claimed  by  various  writers.  Azam 
says  that  in  the  fairs  in  the  South  of  France,  jugglers  hypnotize 
cocks  by  placing  the  bill  oh  a  board,  on  which  they  trace  a  black 
line  passing  between  the  two  feet  of  the  bird.  Cadeac  adds  that 
Father  Kircher,  in  the  17th  century,  employed  a  similar  method 
to  put  fowls  to  sleep.  Alix  put  cats  to  sleep  by  securing  them 
firmly,  and  then  looking  steadily  into  their  eyes.  The  condition 
attained  varies  according  to  the  degree  of  the  sleep,  the  will  being 
dominated  first,  and  later,  consciousness  of  external  objects  is 
lost.  Hypnotism,  however,  appears  to  be  difficult  and  uncertain 
in  the  lower  animals,  in  keeping  with  the  limited  development  of 
intelligence  and  will,  as  compared  with  the  human  being.  Cadeac 
states  that  the  very  old  and  the  very  young  are  completely  refrac- 
tory to  hypnotizing  influences. 

Lesions,  No  constant  pathological  changes  are  found,  though 
different  nervous  lesions  may  serve  to  rouse  the  disease  in  a  pre- 
disposed subject.  Frohner  found  in  the  affected  muscles  granu- 
lar swelling,  fatty  degeneration,  haemorrhages,  and  waxy  (amy- 
loid) degeneration  of  the  cardiac  muscles,  corresponding  to  what 
has  been  found  in  tetanus  ;  also  haemorrhages  on  the  stomach 
and  intestines. 

Symptoms,  The  leading  objective  symptom  is  the  tonic  con- 
dition of  the  muscles  by  which  a  perfect  balance  is  established  and 
maintained  between  the  flexors  and  extensors  so  that  the  affected 
part  maintains  the  same  position  which  it  had  when  the  attack 
began,  or  any  other  position  which  may  be  given  to  it  during  the 


38  Veterinary  Medicine. 

progress  of  the  paroxysm.  The  position  is  only  changed  when 
the  muscles  involved  have  become  completely  exhausted.  Dur- 
ing the  attack  the  affected  muscles  are  swollen  and  firm,  so  that 
their  outline  may  often  be  traced  through  the  skin,  later  as  the 
attack  subsides  they  become  soft  and  flaccid.  Voluntary  move- 
ment of  the  affected  muscles  is  impossible  until  after  the 
paroxysm.  The  attack  usually  comes  on  suddenly  and  in  this 
respect  resembles  epilepsy ;  at  other  times  there  are  premonitory 
symptoms  of  nervous  anxiety,  excitement  or  irritability.  There 
is  usually  considerable  impairment  of  consciousness,  intelligence, 
common  sensation,  and  even  of  the  special  senses.  In  a  cataleptic 
dog  Frohner  noted  mental  and  motor  troubles,  considerable 
anaesthesia,  and  loss  of  sight,  smell,  and  hearing.  The  eyes  are 
fixed,  the  pupils  either  contracted  or  dilated,  and  the  urine 
passed  may  be  albuminous  or  even  icteric. 

Course,  Duration.  Like  other  functional  nervous  disorders 
this  is  extremely  uncertain  in  its  progress.  There  may  be  but 
one  attack  or  a  succession  ;  they  may  last  from  a  few  minutes, 
to  7  days  (Frohner),  or  even  several  weeks  (Hertwig)  ;  they 
may  end  in  recovery  or  less  frequently  they  may  prove  fatal 
usually  by  inanition. 

Treatment,  During  a  seizure  a  sudden  shock  will  sometimes 
cut  short  the  attack,  douching  with  cold  water,  an  inhalation  of 
ammonia,  of  capsicum  or  of  snuff,  or  the  application  of  electricity 
in  an  interrupted  current  through  the  spine  and  affected  muscles. 
Ether  anaesthesia  will  not  always  relax  (Sinkler).  Inhalation 
of  a  few  drops  of  nitrite  of  amyle  has  proved  effective  in  man,  as 
has  also  the  injection  subcutem  of  three  drops  of  a  i  per  cent, 
solution  of  nitro-glycerine ;  apomorphine  hypodermically  is 
usually  effective  (Sinkler).  Bromide  of  potassium  has  also  been 
advised,  and  in  case  of  coldness  of  the  surface,  a  warm  bath. 

When  there  is  overloaded  stomach  and  gastric  indigestion  an 
emetic  is  indicated,  and  in  constipation  a  purgative  (for  speedy 
action  chloride  of  barium  or  physostigma  subcutem). 

In  the  intervals  between  attacks  tonics  and  general  hygiene 
should  be  invoked  to  build  up  the  weakened  nervous  system. 
Quinine,  and  salts  of  iron,  zinc  or  silver  with  a  nourishing  diet 
and  out  door  exercise  are  especially  indicated. 


INSOLATION.      HEAT   EXHAUSTION.      SUNSTROKE. 
THERMIC  FEVER. 

Definition  :  two  forms.  Heat  exhaustion.  Causes :  prolonged  beat, 
and  moisture,  overexertion.  Impaired  vaso- motor  centre.  Failing  heart, 
Carbon  dioxide  poisoning.  Symptoms  :  weak,  fluttering  pulse,  perspiration, 
muscles  flaccid,  prostration,  no  hyperthermia.  Treatment :  stimulant,  digi- 
talis, digitalin,  subcutem,  nitroglycerine,  warm  baths.  Thermic  fever. 
Hyperthermia  excessive.  Causes :  insolation ,  prolonged  heat  and  impure  air, 
furnace  heat,  moist  and  dry  heat,  electric  tension,  overwork,  muscular  ex- 
haustion, coagulation  of  myosin,  constant  heat  on  one  part  (head),  excess  of 
carbon  dioxide,  stiffening  of  bodies  when  killed  in  hot  weather,  debility, 
weakness,  fatigue,  chest  constriction,  tight  girths  or  collars,  short  bearing 
reins,  plethora,  obesity,  open  cars  and  yards,  fever,  privatiou  of  water,  heavy 
fleece.  Lesions  :  right  heart  and  systemic  veins  full,  blood  black  fluid  or 
diffluent,  left  ventricle  empty,  congested  meninges,  effusions  in  or  on  brain, 
or  hemorrhages.  Symptoms  :  horse  :  dull,  stupid,  stubs  toes,  sways  quar- 
ters, droops  head,  hangs  on  bit,  props  on  feet,  breathes  rapidly,  pants,  stertor, 
dUated  nostrils,  gasping,  fixed  eyes,  dilated  pupils,  tumultuous  heartbeats: 
gorged  veins,  epistaxis,  perspiration,  convulsions  ;  ox  :  parallel  symptoms ; 
sheep  :  open  mouth,  stertor,  fixed  eyes,  pupils  dilated,  panting,  swaying, 
fall,  convulsions ;  doff  :  dull,  prostrate,  pants,  congested  veins  and  mucosae, 
weakness,  spasms,  syncope,  speedy  rigor  mortis.  Overheating.  Diagnosis  : 
early  excessive  hyperthermia,  venous  congestion,  shallow  panting  breathing, 
violent  heart  action,  loss  of  sensory  and  motor  f  unci  ions,  convulsions. 
Prevention  :  avoid  violent,  prolonged  heat,  and  exertion,  especially  in  case 
of  fat  animals  or  those  new  to  hot  climate,  keep  emunctories  acting,  shade 
head,  water  on  head  and  to  drink,  protect  fat  cattle,  shear  sheep,  water. 
Treatment :  shade  and  laxatives  ;  if  severe,  cold  water  from  hose,  ice  bags 
to  poll,  rub  legs,  acetanilid  subcutem,  stimulant  enemata,  later  mineral 
tonics,  iron  or  zinc. 

Definition,  A  morbid  condition  produced  by  the  exposure  to 
extreme  heat,  and  marked  by  profound  disorder  of  the  vaso- 
motor  and  heat  centres. 

The  single  term  of  sun-stroke  or  heat-stroke  has  been  replaced 
by  two, — heat  exhaustion  and  sun-stroke,  indicating  two  dis- 
tinct conditions,  brought  about  by  exposure  to  heat  and  mani- 
fested by  different  states  of  the  body  and  distinctive  symptoms. 

Heat  Exhaustion. 

This  appears  as  an  exaggerated  form  of  the  general  sense  of 
relaxation,   weakness  and  languor  which  follows  on  prolonged 
39 


40  Veterinary  Medicine, 

violent  exertion  in  a  hot  atmosphere.  There  is  more  or  less  im- 
pairment of  the  vaso-motor  nerve  centre  in  the  medulla,  relaxa- 
tion of  the  capillary  system,  and  flagging  of  the  heart's  action, 
which  loses  its  customary  stimulus,  by  reason  of  the  defective 
supply  of  blood  returned  by  the  veins.  This  may  become  so  ex- 
treme that  the  patient  dies  by  syncope.  In  other  cases  the 
paresis  is  mainly  shown  in  the  vaso-motor  system,  and  its  centres 
in  the  medulla,  the  blood  is  delayed  in  the  distended  capillaries 
and  veins,  it  becomes  overcharged  with  carbon  dioxide,  the 
heart's  action  is  accelerated  and  feeble,  the  pulse  rapid,  weak 
and  fluttering,  perspiration  breaks  out  on  the  skin,  and  the  tem- 
perature is  normal  or  subnormal.  The  muscular  weakness,  the 
flaccid  condition  of  the  facial  muscles,  and  general  depression 
suggest  a  state  of  coUaps^.  This  condition  is  not  necessarily  due 
to  exposure  to  the  intensity  of  the  sun's  rays,  but  may  come  on 
in  animals  subjected  for  a  length  of  time  to  artificial  heat,  and 
especially  if  the  air  is  impure,  and  if  the  subject  has  to  undergo 
severe  physical  exertion. 

Treatment.  In  slight  cases  of  this  kind  a  stimulant  is  usually 
desired  and  ammonium  carbonate  in  bolus  or  solution  will 
usually  serve  a  good  purpose.  In  its  absence  alcohol  or  spirits 
of  nitrous  ether  may  be  given.  Digitalis  is  of  great  value  in 
sustaining  the  flagging  action  of  the  heart  and  has  the  advantage 
that  as  digitalin  it  can  be  given  hypodermically  when  it  is  im- 
possible to  give  ammonia,  alcohol  or  ether  by  the  mouth.  For 
the  same  reason  nitro- glycerine  may  be  resorted  to,  or  even 
atropia  as  a  vaso-motor  stimulant.  Active  friction  of  the  body 
and  limbs  will  aid  circulation  and  indirectly  stimulate  the  heart, 
and  in  case  of  subnormal  temperature  it  may  be  supplemented 
by  a  warm  bath  in  the  smaller  animals,  kept  up  until  the  normal 
temperature  in  the  rectum  has  been  restored. 

Thermic  Fever.     Sun-stroke. 

This  is  readily  distinguished  from  heat  exhaustion  by  the  pre- 
dominance of  the  hyperthermia.  While  in  heat  exhaustion 
the  temperature  is  usually  subnormal,  in  sun-stroke  it  is  exces- 
sive, (108^-113^  F.). 

Causes,  The  immediate  cause  of  sunstroke  is  exposure  to 
undue  heat,  but  this  need  not  be  the  heat  of  the  sun's  rays  direct. 


Insolation.     Sun- stroke.     Thermic  Fever.  41 

A  large  proportion  of  cases  in  the  human  subject  are  attacked 
during  the  night,  and  again  at  sea  where  an  attack  in  a  passenger 
is  practically  unknown,  it  is  terribly  common  among  stokers 
working  in  a  close  atmosphere  of  100®  to  150**  F. 

The  attendant  conditions  have  much  influence  in  determining 
an  attack,  thus  it  is  generally  held  that  heat  with  excess  of  moist- 
ure is  the  most  injurious,  yet  in  Cincinnati,  statistics  showed  a 
greater  number  of  cases  in  man  when  the  air  was  dry.  The  sup- 
pression of  perspiration  and  the  arrest  of  cooling  by  evaporation 
in  the  latter  case  would  tend  to  a  rapid  increase  of  the  body  tem- 
perature, and  the  condition  would  be  aggravated  by  the  electric 
tension  usually  present  with  the  dry  air.  With  the  hot,  moist  air 
perspiration  might  continue,  but  evaporation  would  be  hindered, 
and  there  would  be'  arrest  of  the  cooling  process  and  an  extreme 
relaxation  of  the  system. 

Again,  it  is  usually  found  that  seizures  take  place  during  or 
after  hard  muscular  exertion  in  a  hot  period,  and  much  importance 
is  attached  to  the  attendant  exhaustion,  the  excess  of  muscular 
waste,  and  the  alteration  of  the  myosin,  which  latter  coagulates 
at  a  lower  temperature  in  the  over-worked  animal.  But  on  the 
other  hand,  experiment  shows  that  the  animal  confined  to  abso- 
lute inactivity  in  the  hot  sunshine  or  in  a  high  temperature  (at 
90**),  dies  in  a  few  hours,  whereas  another  animal  left  at  liberty 
in  the  same  temperature  does  not  suffer  materially.  The  explana- 
tion appears  to  be  that  the  dog,  kept  absolutely  still,  iias  the  contin- 
uous action  of  the  heat  on  the  same  parts  and  on  the  same  blood, 
for  the  capillaries  dilate,  and  the  blood  is  delayed,  overheated, 
and  surcharged  with  carbon  dioxide,  and  the  result  is  either  syn- 
cope from  heart  failure,  or  asphyxia  from  excessive  carbonization 
of  the  blood.  Back  of  these  and  concurring  with  them  is  the  par- 
alysis of  the  vaso-motor  and  heat  generating  nerve  centres,  from 
the  high  temperature  or  the  condition  of  the  blood. 

The  excessive  carbonization  of  the  blood  deserves  another  word. 
The  prolonged  contact  of  the  blood  and  air  in  the  lungs  is  essen- 
tial to  the  free  interchange  of  oxygen  and  carbon  dioxide.  Vie- 
rordt  showed  that  with  sixty  respirations  per  minute  the  expired 
air  became  charged  with  but  2.4  per  cent,  of  this  gas,  whereas 
with  fourteen  respirations  it  contained  4.34  per  cent.  Therefore, 
with  violent  muscular  work  (which  charges  the  blood  with  carbon 


42  Veterinary  Medicine. 

dioxide)  and  rapid  breathing  (which  fails  to  secure  its  elimina- 
tion), the  over-driven  animal  soon  perishes  from  asphyxia.  Un- 
der a  high  temperature  of  the  external  air,  this  condition  is  aggra- 
vated since  the  rarified  air  contains  just  so  much  the  less  oxygen, 
the  absorption  of  which  is  the  measure  of  the  exhalation  of  car- 
bon dioxide. 

Dr.  H.  C.  Wood,  who  has  experimented  largely  on  the  subject 
in  animals,  finds  the  cause  of  heart  failure  in  the  coagulation  of 
the  myosin;  which  takes  place  under  ordinary  circumstances  at 
1 15**  F. ,  but  at  a  much  lower  temperature  when  a  muscle  has  been 
in  great  activity  immediately  before  death.  As  the  temperature 
of  thermic  fever  frequently  reaches  1 13®,  or  even  higher,  he  easily 
accounts  for  the  sudden  syncope  occurring  during  active  work  in 
a  high  temperature.  As  an  example  of  such  sudden  rigor,  he  ad- 
duces the  sudden  stiffening  of  the  bodies  of  some  soldiers  killed 
in  battle  during  hot  weather. 

Wood  further  shows  that  all  the  symptoms  of  thermic  fever  can 
be  produced  in  the  rabbit  by  concentrating  the  temperature  on  its 
head,  which  seems  to  imply  a  direct  action  on  the  brain  and  in  par- 
ticular on  the  heat  producing  and  vaso- motor  centres.  This  becomes 
the  more  reasonable  that  the  temperature  attained  does  not  im- 
pair the  vitality  of  the  blood  but,  leaves  the  leucocytes  possessed 
of  their  amoeboid  motion.  He  found,  moreover,  that  if  the  heat 
were  withdrawn  before  it  has  produced  permanent  injury  to  the 
nervous  systepi,  blood  or  other  tissues,  the  convulsions  and  un- 
consciousness are  immediately  relieved  and  the  animal  recovers. 

Other  conditions  may  be  adduced  as  predisposing  or  concurrent 
causes  of  thermic  fever.  Whatever  impairs  the  animal  vigor  has 
this  effect.  Fatigue,  as  already  noticed,  is  a  potent  factor,  in 
man  a  drinking  habit ;  in  all  animals  a  long  persistence  of  the 
heat  during  the  night  as  well  as  the  day  ;  impure  air  in  badly 
ventilated  buildings  ;  and  mechanical  restriction  on  the  freedom 
of  breathing.  In  military  barracks  with  the  daily  temperature  at 
118**  F.  and  the  night  temperature  105,  the  mortality  became  ex- 
treme, and  in  close  city  car  stables  the  proportion  of  sun-strokes  is 
enhanced.  In  all  such  cases,  the  air  becomes  necessarily  more 
and  more  impure  continually.  The  atmosphere  has  the  same 
heat  as  the  animal  body,  so  that  no  upward  current  from  the  lat- 
ter can  be  established,  to  create  a  diffusion.     The  carbon  dioxide 


Insolatwn,     Sun-stroke.     Tkermk  Fever.  43 

and  other  emanations  from  the  longs,  the  exhalations  from  the 
skin,  dung  and  urine,  accumulate  in  the  air  immediately  sur- 
rounding the  animal  and  respiration  becomes  increasingly  imper- 
fect and  difficult.  This  condition  is  further  aggra\'ated  by  the 
accumulation  of  the  animal  heat  in  the  body.  The  blood  circu- 
lating in  the  skin  can  no  longer  be  cooled,  to  return  with  refrig- 
erating effect  on  the  interior  of  the  body,  the  cooling  that  would 
come  from  the  evaporation  of  sweat  is  obviated  by  the  suppres- 
sion of  that  secretion,  as  well  as  by  the  saturation  of  the  zone  of 
air  immediately  surrounding  the  body,  and  thus  the  tendency  is 
to  a  steady  increase  of  the  body  temperature  until  the  limit  of 
viability  has  been  passed. 

The  mechanical  restriction  of  respiration  should  not  be  over- 
looked. In  European  soldiers  landed  in  India  and  marched  in 
the  tight  woolen  clothing  and  close  stocks  a  high  mortality  has 
been  induced  and  in  horses  with  tight  girths  or  collars  and  short 
bearing  reins,  and  oxen  working  in  collars  a  similar  result  is  ob- 
served.    Any  condition  of  fever  is  a  potent  predisposing  factor. 

Horses  or  cattle  that  are  put  to  violent  or  continued  exertion 
when  too  fat  or  out  of  condition  are  especially  subject  to  sun- 
stroke. Pat  cattle  driven  to  market  under  a  hot  sun,  or  shipped 
by  rail,  crowded  in  a  car  and  dela3red  on  a  siding  under  a  hot  sun, 
with  no  circulation  of  air,  often  have  insolation  in  its  most  violent 
form.  The  same  may  be  seen  in  the  hot  stockyard,  with  a  still 
atmosphere  and  the  fat  animals  subjected  to  the  full  blaze  of  a 
July  sun.  The  chafed  feet  caused  by  travel,  and  the  muscular 
weariness  caused  by  standing  in  the  moving  car  are  material  ad- 
ditions to  the  danger. 

Similarly  horses  suffer  on  the  race  track  when  subjected  to 
protracted  and  severe  work  in  hot  weather,  or  again  dragging 
loads  in  a  heated  street  under  a  vertical  sun,  or  on  a  side  hill, 
with  the  sun's  rays  striking  perpendicularly  to  its  sifrface. 

A  change  in  latitude  has  a  decided  effect,  the  Northern  horse 
suffering  much  more  frequently  than  the  one  which  is  native  to 
the  Southern  States  and  which  has  inherited  the  habit  of  heat 
endurance. 

Finally  faults  in  feeding  and  above  all  watering  are  appreciable 
factors.  The  privation  of  water  in  particular  is  to  be  dreaded. 
Tracy  in  his  experience  with  American  soldiers  in  Arizona  found 


44  Veterinary  Medicine. 

that  the  command  could  usually  be  guarded  against  sun  stroke 
when  a  supply  of  water  was  kept  on  hand.  It  should  be  used 
guardedly,  but  nothing  would  act  better  in  obviating  an  attack. 
On  the  other  hand,  when  the  canteens  were  empty,  under  the 
hot  sun  the  seizures  increased  disastrously. 

Sheep  are  especially  liable  to  sufiFer  from  heat  by  reason  of 
their  dense  fleece,  which  hinders  the  evaporation  of  perspira- 
tion, and  the  cooling  effect  of  air  on  the  skin.  When  the 
temperature  rises,  respiration  is  accelerated  and  panting,  the 
lungs  seeking  to  supplement  the  work  of  the  skin.  When 
traveling  in  a  heavy  fleece,  or  in  the  hot  sunshine  in  July  or 
August  sun  stroke  is  not  uncommon  among  them. 

Lesions.  Among  the  lesions  ^may  be  named,  vacuity  of  the 
left  ventricle  and  fullness  of  the  right  ventricle  and  veins  with 
fluid  blood  or  a  diffluent  clot ;  Congestion  of  the  pia  or  dura 
mater,  effusion  into  the  ventricles,  haemorrhages  into  the  sub- 
serous tissues,  and  degeneration  of  the  muscles. 

Symptoms,  Horse.  When  premonitory  symptoms  are  ob- 
served the  animal  fails  to  respond  to  whip  or  voice,  lessens  his 
pace,  stubs  with  his  fore  feet  and  sways  with  the  hind,  depresses 
his  head  and  hangs  heavily  on  the  bit. 

Too  often  these  are  omitted  or  overlooked,  and  the  horse  sud- 
denly stops,  props  himself  on  his  four  limbs,  drops  and  extends 
the  head,  breathes  with  great  rapidity,  -panting  and  even  stertor, 
dilates  the  nostrils  widely,  retracts  the  angle  of  the  mouth  and 
even  gapes,  has  the  eyes  fixed,  the  pupils  dilated  and  the  beats 
of  the  heart  tumultuous.  The  superficial  veins  are  distended,  the 
visible  mucosae  congested  with  dark  blood,  and  blood  may  escape 
from  the  nose.     Perspiration  usually  sets  in. 

The  animal  may  fall  and  die  in  a  few  minutes  in  convulsions, 
or,  if  stopped  sufficiently  early  and  suitably  treated,  he  may  in  a 
measure  recover  in  15  to  20  minutes. 

Symptoms.  Ox.  The  premonitory  symptoms  are  like  those 
in  the  horse  :  dullness,  rapid  panting,  breathing,  the  mouth  is 
opened  and  the  pendent  tongue  is  covered  with  frothy  saliva,  a 
frothy  mucus  escapes  from  the  nose,  the  eyes  are  congested  and 
fixed,  the  pupils  dilated,  the  nostrils  and  flanks  work  laboriously, 
the  heart  palpitates,  the  animal  sways  or  staggers  and  falls. 
Death  follows  in  convulsions,  or  it  may  be  delayed,  the  animal 


Insolation .     Sun-stroke,     Thermic  Fever.  45 

struggling  ineflFectually  tp  rise,  or  having  periods  of  comparative 
quiet.  The  rectal  temperature  is  very  high,  107**  to  114°  F.  If 
able  to  stand,  there  is  usually  blindness  and  heedlessness  of  sur- 
rounding objects. 

Symptoms.  Sheep.  The  oi^n  mouth,  protruding  tongue, 
frothy  saliva,  reddened  fixed  eyes,  rapid  breathing,  beating 
flanks,  stertor,  and  unsteady  gait  are  characteristic  when  taken 
along  with  the  manifest  causes.  Swaying  movements  followed 
by  a  sudden  fall  and  death  in  convulsions  form  the  usual  termina- 
tion of  the  disease. 

Symptoms.  Dog.  These  have  been  mainly  produced  experi- 
mentally and  consisted  in  hyperthermia,  dullness,  prostration, 
accelerated  breathing  and  heart  action,  congested  veins,  and 
mucosae,  muscular  weakness,  convulsions,  and  syncope  or  as- 
phyxia. After  death  the  muscles  became  speedily  rigid,  and 
the  blood  accumulated  in  the  venous  system,  was  fluid  or  only 
loosely  coagulated.  In  these  animals,  if  the  experiment  were 
stopped  in  time  the  animal  could  be  restored  to  health. 

Slighter  cases  may  occur  in  the  different  animals,  more  partic- 
ularly from  overdriving  in  hot  weather,  and  in  such  cases  the 
overheated  animal  recovers,  but  there  is  liable  to  remain  a  special 
sensitiveness  to  excessive  heat  and  a  tendency  to  be  dull,  sluggish 
and  short  winded,  to  hang  the  head  in  hot  weather,  and  to  seek 
shelter  from  the  direct  rays  of  the  sun. 

Diagnosis  is  largely  based  on  the  suddeness  of  the  attack,  on 
the  occurrence  of  high  temperature  before  the  seizure,  not  after  as 
it  is  liable  to  be,  if  at  all,  in  apoplexy,  on  the  dark  congestion  of 
the  mucosae,  and  of  the  venous  system,  on  the  rapidity  .and  shal- 
lowness of  the  respirations,  on  the  tumultous  action  of  the  heart, 
and  on  the  general  loss  of  sensory  and  especially  of  motor  func- 
tion, in  circumstances  calculated  to  induce  sunstroke.  Localized 
paralysis  or  spasm  would  suggest  the  formation  of  a  cerebral  ef- 
fusion or  clot. 

Prevention.  This  will  depend  on  the  class  of  animal  and  its 
conditions  of  life  and  work.  In  horses  care  should  be  taken 
to  regulate  the  work  by  the  heat  of  the  season  and  condition  of 
the  animal.  When  the  temperature  ranges  from  80°  to  100°  F. 
the  work  should  be  lessened  and  every  attention  should  be  given 
to  maintain  the  healthy  functions  (bowels,  kidneys,  skin)  in  good 


46  Veterinary  Medicine. 

working  condition.  If  the  horse  is  young,  fat,  or  out  of  condi- 
tion from  idleness  or  accumulation  of  fat  he  must  have  the 
greater  consideration.  So  it  is  with  a  horse  recently  come  from  a 
colder  latitude,  and  with  a  heavy  draught  horse  that  may  be 
called  on  to  do  rapid  work.  Some  protection  is  secured  by  wear- 
ing a  sunshade  or  wet  sponge  over  the  poll,  and  much  may  be 
expected  from  an  occasional  rest  in  the  shade,  a  swallow  of  cool 
water  and  sponging  of  the  head. 

Very  heavy  fat  cattle  should  not  be  driven  far  nor  shipped  pn 
the  hottest  days,  and  the  packed  car  should  not  be  left  in  the 
full  sunshine  in  a  still  atmosphere.  Yards  with  sheds  under 
which  they  can  retreat  must  be  secured  if  possible. 

The  heavily  fleeced  sheep  must  have  equal  care  and  the  pastures 
for  fat  sheep  and  cattle  should  have  available  shade  in  form  of  , 
trees,  walls  or  sheds.    Access  to  water  is  an  important  condition. 

Treatment.  In  slight  cases  {overheated)  a  few  days  of  rest, 
under  an  awning  rather  than  in  a  close  stable,  with  a  restricted 
and  laxative  diet. 

In  severe  thermic  fever  the  first  consideration  is  to  lower  tem- 
perature. If  available  turn  a  hose  on  the  head,  neck  and  entire 
body  for  five  or  ten  minutes,  or  until  the  rectal  temperature  ap- 
proaches the  normal.  In  the  absence  of  such  a  water  supply, 
dash  cold  water  from  a  well  on  the  body  but  especially  the  head 
and  neck,  and  if  available  tie  a  bag  of  ice  around  the  poll.  Active 
friction  to  the  legs  and  body  is  often  of  great  advantage.  A  large 
dose  of  antipyrin  or  acetanilid  may  be  given  hypodermically.  On 
the  other  hand  stimulants,  and  especially  carbonate  of  ammonia, 
or  sweet  spirits  of  nitre  may  be  given  as  an  enema.  This  may 
be  repeated  in  an  hour  in  case  the  pulse  fails  to  acquire  force  and 
tone. 

Should  the  temperature  rise  again  later  it  may  often  be  kept  in 
check  by  cold  sponging  and  scraping  followed  by  rubbing  till 
dry. 

In  case  of  continued  elevation  of  temperature,  with  heat  of  the 
head,  and  perversion  of  sensory  or  motor  functions,  meningitis 
may  be  suspected  and  appropriate  treatment  adopted. 

For  the  prostration  and  weakness  that  is  liable  to  follow  therm- 
ic fever,  mineral  tonics  such  as  the  salts  of  iron  or  zinc  may  be 
resorted  to. 


EPILEPSY.     FALLING  SICKNESS. 

Definition.  Frequency.  Susceptibility :  dogs,  pigs,  cattle,  horses,  par- 
rots, sparrows.  Divisions:  slight  and  severe  ;  Jacksonian  (partial) ;  sympto- 
matic ;  idiopathic.  Lesions  ;  inconsUnt ;  of  brain,  cranium,  cerebral  circu- 
lation, myelon,  poisons  in  blood,  dentition,  cortical  and  ganglionic  lesions, 
cerebral  asymmetr}-,  stenosis  of  vertebral  canal.  Medullar  asymmetry, 
timnmas  of  cranium,  aneemia,  bleeding,  carotid  ligation,  spinal  reflexes, 
irritation  of  the  skin,  creatioin,  dncbonoidin,  lead,  ergot,  nitropentan, 
nitro-benzol.  ptomaines,  toxins,  parasites,  nerve  lesions,  local  hyperae^thesia 
(withers  of  horse,  recurrent  ophthalmia),  indigestion,  constipation,  sciatic 
neuritis.  Causes :  nervous  predisposition,  heredity  (man,  cat,  dog,  ox), 
sexual  excitement,  fear,  sudden  strong,  visual  impression,  uric  acid  in 
blood,  meat  diet  Symptoms:  hone,  sudden  seizure,  bracing  feet  and 
limbs,  swa}ing,  fall,  convulsive  rigidity,  jaws  working  or  clenched,  eyes 
rolling,  salivation,  stertor,  dyspnoea,  sensation  absent.  Duration.  Symp- 
toms of  localized  epilepsy.  Cattle,  bellow,  stertor,  rolling  eyes,  jerking 
rigidity,  fall.  Sheep.  Swine.  Premonitory  malaise,  jerking,  champing 
jaws,  fall,  trembling,  rigidity,  involuntary  discharges.  Doff :  trembles, 
cries,  falls,  rigidity,  clonic  contractions,  stertor,  sequelae.  Diagnosis: 
fudden  attack,  unconsciousness,  spasms,  quick  recovery,  no  spasms  in 
cyncope,  vertigo  has  no  spasms,  thrombosis  has  symptoms  developed  by  ex- 
ercise. Jurisprudence :  animal  returnable  after  twenty-eight  days  ( Wurten- 
berg,  etc.),  thirty  days  (Prance).  Treatment :  of  susceptible  brain,  and 
peripheral  irritant.  Correct  all  irritation  or  disease,  or  expel  parasites. 
Nerve  sedations  :  bromides,  opium,  valerian,  belladonna,  hyosdne,  duboi- 
sine.  Tonics :  rinc,  arsenic,  silver,  baths,  electricity.  Borax.  Vegetable 
diet.  Castration.  Avoidance  of  excitement.  Surgical  operations.  Tre- 
phining. Excision  of  cortex.  Outdoor  life.  During  a  fit :  amyle  nitrite, 
chloroform,  ether,  chloral,  warm  hath,  cold  or  warmth  to  head,  quiet  se- 
cluded place. 

Epilepsy  is  the  name  given  to  a  class  of  cases  characterized  by 
a  sudden  and  transient  loss  of  consciousness  with  a  convulsive 
seizure,  partial  or  general.  It  appears  to  be  due  to  a  sudden  ex- 
plosive discharge  of  convulsive  nervous  energy,  which  may  be 
generated  by  a  great  number  of  catises  of  morbid  irritation — 
pathological,  traumatic,  or  toxic.  As  a  rule  the  epileptic  seizure 
is  but  the  symptomatic  expression  of  a  complex  derangement 
which  may  be  extremely  varied  as  to  its  nature  and  origin. 

Frequency  in  different  animals.  The  affection  is  far  less  fre- 
quent in  the  domestic  animals  than  in  man,  doubtless  becatLse  of 
47 


48  Veterinary  Medicine, 

the  absence  of  the  special  susceptibility  which  attends  on  the 
more  highly  specialized  brain,  the  disturbing  conditions  of  civ- 
ilization, and  the  attendant  vices. 

Among  domestic  animals,  dogs  are  the  most  frequent  victims 
in  keeping  with  their  relatively  large  cerebral  development,  their 
emotional  and  impressionable  nature  and  the  unnatural  and  arti- 
ficial conditions  in  which  as  house  pets  they  are  often  kept. 
Their  animal  food  and  the  consequent  uric  acid  diathesis  is  a 
probable  cause,  as  it  is  in  man.  In  ten  years  of  the  dog  clinic  at 
Alfort  they  made  an  average  of  3  per  cent,  of  all  cases.  Next  to 
the  dog  the  pig  kept  in  confinement  is  the  most  frequent  victim, 
while  cattle  and  horses  come  last.  At  the  Alfort  clinic  epileptic 
horses  were  not  more  than  i  per  1000  patients.  It  is  not  at  all 
unfrequent  in  birds,  especially  canaries  and  parrots.  Reynal 
has  seen  it  in  sparrows. 

Divisions.  The  disease  has  long  been  divided  into  petit  mal 
^nA  grand  mat  (hautmai).  The  petit  mal  (slight  attack)  is 
usually  a  transient  seizure  affecting  a  group  of  muscles  only  and 
associated  with  only  a  momentary  or  very  transient  loss  of  con- 
sciousness. The  loss  of  consciousness  is  uncertain  in  many 
cases.  Under  partial  epilepsies  must  be  included  the  hemi- 
epilepsy,  or  Jacksonian  epilepsy,  which  is  confined  to  one  side  of 
the  body. 

The  grand  mal  (severe  attack)  is  one  in  which  the  loss  of 
consciousness  is  complete,  and  the  convulsions  are  general  in  the 
muscles  of  animal  life. 

Another  division  is  into  symptomatic  and  idiopathic  cases, 
and  if  this  distinction  could  always  be  made  it  would  be  of  im- 
mense value  in  the  matters  of  prognosis  and  treatment  as  the  re- 
moval of  the  morbid  state  of  which  epilepsy  is  the  symptom  will 
usually  restore  the  patient  to  health.  Thus  the  removal  of 
worms  from  the  alimentary  canal,  of  indigestible  matters  from 
the  stomach,  of  a  depressed  bone  or  tumor  from  the  surface  of 
the  brain  may  in  diflFerent  cases  be  the  essential  condition  of  a 
successful  treatment. 

Morbid  Anatomy  and  Pathology.  The  literature  of  epilepsy  is 
very  rich  and  extensive  and  yet  no  constant  lesions  of  the  ner- 
vous system  can  be  fixed  on  as  the  local  cause  of  the  disease.  A 
review  of  the  whole  literature  leads  rather  to  the  conclusion  that 


Epilepsy,      Falling  Sickness,  49 

irritations  coming  from  lesions  of  the  most  varied  kind,  acting  on 
a  specially  susceptible  brain  wiU  rouse  the  cerebral  centres  to  an 
epileptic  explosion.  Thus  epilepsy  has  been  found  to  be  asso- 
ciated with  lesions  of  the  following  kinds  : 

ist.  Brain  lesions  of  almost  every  kind, including  malformations. 

2nd.  Lesions  of  the  walls  of  the  cranium. 

3d.  Disorders  of  the  cerebral  circulation. 

4th.  Lesions  of  the  spinal  cord. 

5th.  Morbid  states  of  the  circulating  blood  (excess  of  urea, 
uric  add,  creatinin,  lead  poisoning.) 

6th.  Reflected  irritation,  as  from  dentition,  worms,  sexual  ex- 
cesses, injuries  to  certain  nerves,  notably  the  sciatic,  or  to  par- 
ticular parts  of  the  skin. 

ist.  Brain  lesions.  Those  which  affect  the  medulla  and  the 
cortical  convolutions  around  the  fissure  of  Rolando  would  be  ex- 
pected to  be  implicated  because  these  centres  preside  over  the 
principal  motor  actions  of  the  body  and  limte.  Yet  though 
these  parts  are  found  to  be  affected  with  various  morbid  lesions 
in  a  certain  number  of  cases  of  epilepsy,  such  lesions  are  ex- 
ceptional, rather  than  the  rule.  In  20  cases  of  epilepsy  in  man, 
15  showed  no  lesion  whatever  of  the  brain.  Blocq  and  Marinesco, 
pupils  of  Charcot,  recently  made  a  critical  examination  of  the 
medulla  and  Rolandic  cortex  in  nine  cases  that  died  during  the 
fit.  All  showed  granular  bodies  (degenerated  myelin  or  blood 
pigment)  in  the  perivascular  sheaths  but  they  found  these  in  dis- 
seminated sclerosis  and  even  in  healthy  brains  as  well.  The  neuro- 
glia cells  of  the  first  cortical  layer  contained  black  granules. 
Otherwise  four  cases  had  no  change,  while  five  showed  sclerosis  of 
the  cortex.  The  medulla  was  sound  in  aU  cases  excepting  one 
which  showed  punctiform  haemorrhages.  Visible  lesions  may  be 
present  in  other  parts  of  the  brain  ;  Wenzel  long  ago  claimed 
constant  lesion  of  the  pituitary  body.  Beside  the  cerebral  cortex, 
lesions  have  been  found  in  the  bulb,  the  h3rpoglossal  nucleus, 
the  olivary  body,  the  hippocampi,  the  thalamus,  the  corpus 
striatum,  the  quadrigemini,  the  cerebellum,  etc.  Hughlings- 
Jackson  who  made  an  extended  investigation  of  the  subject  con- 
cludes that  any  part  of  the  gray  matter  of  the  encephalon  may 
become  over-exdtable  and  give  rise  to  a  convulsive  attack.  Not 
4 


50  Veterinary  Medicine, 

only  may  the  lesion  be  in  any  part  of  the  brain,  but  it  may  be  of 
any  kind  :  meningitis,  cerebritis,  softening,  tubercle,  tumor,  hy- 
datid, embolism,  or  dropsy.  Marie  Bra  found  an  extreme  asym- 
metrj'  of  the  cerebral  lobes  in  epileptics.  Kussmaul  and  others 
found  stenosis  of  the  vertebral  canal  and  asymmetry  of  the  two 
lateral  halves  of  the  medulla. 

2nd.  Cranial  lesions.  These  consist  largely  in  blows  or 
falls  upon  the  head,  with  ostitis,  periostitis,  fractures  with  de- 
pressions, fibrous  neoplasia  implicating  or  not  the  meninges  and 
pressing  on  the  brain,  haemorrhages  from  minute  arteries,  etc. 
The  diagnosis  of  such  lesions  will  often  open  a  way  to  a  success- 
ful treatment.  Baker  found  most  of  the  severe  cases  from  head 
injuries. 

3d.  Disorders  of  the  cerebral  circulation.  Burrows, 
Kussmaul  and  Turner  showed  that  in  animals,  loss  of  conscious- 
ness and  epileptiform  convulsions  followed  on  cerebral  anaemia 
caused  by  profuse  bleeding  or  by  compression  of  the  carotids. 
The  same  has  been  observed  in  surgical  cases  after  ligation  of 
one  common  carotid.  Hermann  caused  convulsions  in  a  rabbit 
by  ligating  both  anterior  and  posterior  venae  cavae. 

4th.  Lesions  of  the  Spinal  Cord.  Brown-Sequard  determined 
epileptiform  convulsions  by  transverse  section  of  one  half  of  the 
spinal  cord,  or  of  its  superior,  lateral  or  inferior  columns.  The 
later  development  of  the  doctrine  of  interrupted  spinal  inhibition, 
suggests  that,  many  of  the  seizures  in  question  are  but  exaggera- 
ted spinal  reflexes,  which  are  no  longer  restrained  by  cerebral  in- 
hibition. That  all  are  not  of  this  spurious  kind  may  be  fairly 
inferred  from  his  further  demonstration  that  bruising  of  the  great 
sciatic  in  animals  tended  to  produce  epilepsy.  In  such  cases  the 
irritation  of  certain  areas  by  pinching  the  skin,  served  to  produce 
a  seizure.  Not  only  so,  but  the  animals  in  which  such  artificial 
epilepsy  had  been  induced  tended  to  transmit  the  infirmity  to 
their  progeny.  The  prevailing  view  of  epilepsy  however,  would 
consider  such  lesions  as  sources  of  peripheral  irritation  by  which 
the  brain  is  affected  sympathetically,  while  the  real  explosion  is 
the  result  of  the  sudden  discharge  of  the  pent  up  excitement 
caused  in  the  encephalic  centres  by  the  irritation  at  such  distant 
points. 


Epilepsy,      Falling  Sickness.  51 

5th.  Morbid  States  of  the  Circulating  Blood.  Certain 
poisons,  when  brought  in  contact  with  encephalic  nerve  centres 
produce  epileptic  seizures.  Gallerani  and  Lussana  applied 
creatinin  directly  to  the  cerebral  cortex  and  quickly  induced 
epileptiform  convulsions  and  choreiform  movements.  Injected 
subcutaneously  it  failed  to  produce  the  same  effect.  Cinchonoidin 
acted  on  the  basal  ganglia  of  the  brain  producing  convulsions 
but  no  choreiform  movement.  Poisoning  with  lead,  ergot,  nitro- 
pentan,  nitro-benzol  and  a  number  of  other  poisons  brings  about 
intermittent  convulsive  seizures.  The  same  may  be  inferred  of 
ptomaines  and  toxins,  in  the  convulsions  that  appear  in  the  ad- 
vanced stages  of  infectious  diseases  (canine  distemper,  hog 
cholera,  etc.). 

6th.  Reflex  Irritation.  Perhaps  no  peripheral  irritation 
more  frequently  causes  epilepsy,  than  parasites.  In  young  dogs 
worms  in  the  intestines  (taenia  coenurus,  taenia  tenuicoUis,  taenia 
serrata,  taenia  echinococcus,  and  ascarides)  have  been  especially 
incriminated.  Also  linguatula  taenioides  in  the  nasal  sinuses.  In 
young  pigs  the  echinorrhynchus  gigas,  ascarides  and  trichocepha- 
lus.     In  horses  ascarides  have  been  principally  blamed. 

Wounds  implicating  nerves,  and  tumors  pressing  on  nerves, 
have  served  as  sources  of  nervous  excitement  which  accumulates 
in  the  cerebral  ganglia  and  bursts  forth  as  an  epileptic  explosion. 
Bourgelat  mentions  the  case  of  a  horse  which  fell  in  a  fit  the 
moment  he  was  touched  on  his  tender  withers,  also  a  case  in 
which  a  seizure  coincided  with  an  attack  of  recurrent  ophthalmia. 
Gerlach  saw  a  horse  which  had  an  epileptic  fit  the  instant  he  was 
touched  on  his  sensitive  withers.  In  kittens  and  puppies  the 
irritation  attendant  on  dentition  is  a  common  cause  of  attacks.  In 
nervous  dogs  and  pigs  indigestion  or  constipation  may  serve  as 
the  occasion  of  an  explosion.  In  the  experimental  cases  of 
Brown-Sequard,  not  only  did  the  injury  to  the  sciatic  nerve  de- 
velop in  the  brain  a  latent  tendency  to  epilepsy,  but  the  subse- 
quent pinching  of  the  skin  in  certain  areas  (epileptigenous  zones) 
promptly  brought  about  a  seizure. 

Causes.  Most  of  the  causes  of  epilepsy  have  been  given 
above  under  the  head  of  pathology  and  morbid  anatomy.  The 
nervous  predisposition  may,  like  any  other  peculiarity  or  function, 
become  hereditary.     In  the  human  race  nothing  is  more  certain 


52  Veterinary  Medicine, 

than  the  tendency  to  some  form  of  nervous  disorder  (insanity, 
dementia,  alcoholism,  morphinism,  epilepsy,  chorea,  etc.)  in  a 
special  family  line.  Reynal  records  the  case  of  an  epileptic  cat 
(belonging  to  an  employe  of  the  Alfort  veterinary  school)  the 
progeny  of  which  for  three  generations,  became  affected  with 
epilepsy  and  mostly  died  before  they  were  a  year  old.  Also  four 
epileptic  dogs  (3  males  and  i  female)  which  produced  a  num- 
ber of  epileptic  puppies.  LaNotte  records  the  cases  of  two  bulls 
affected  with  epilepsy,  in  the  progeny  of  which  numerous  cases  of 
epilepsy  appeared  ;  the  cows  being  attacked  after  the  first  calving, 
and  the  oxen  soon  after  they  were  first  put  to  work.  Breeding 
stallions  are  particularly  liable  to  attacks,  the  high  feeding,  lack 
of  muscular  work  in  the  open  air,  and  above  all  the  oft  repeated 
nervous  excitement  attendant  on  copulation  being  directly  ex- 
citing causes.  The  heredity  of  the  artificial  epilepsy  induced  by 
Brown-Sequard  in  Guinea  pigs,  serves  to  strengthen  the  doctrine 
of  heredity  in  ordinary  forms. 

Among  emotional  causes  fear  easily  heads  the  list.  Bernard 
states  that  a  horse  became  epileptic  in  connection  with  the  terror 
caused  by  the  giving  way  of  a  wooden  bridge  over  which  he  was 
passing.  Bourgelat  and  Reynal  adduce  instances,  in  cavalry 
horses  when  first  put  under  fire.  Reynal  records  the  case  of  an- 
other which  had  his  first  attack  when  facing  a  moving  locomo- 
tive, and  which  never  again  could  see  an  engine  in  motion 
without  suffering  another  attack.  La  Notte  mentions  the  case  of 
a  horse  attacked  when  frightened  by  a  sky  rocket  ;  Romer,  the 
case  of  a  horse  scared  by  the  sudden  display  of  a  white  sheet  in 
front  of  him,  and  Friedberger  and  Frohner  relate  cases  of  attacks 
caused  by  intense  rays  of  light,  as  in  racing  toward  the  declining 
sun,  or  the  dazzling  reflection  from  the  surface  of  the  water. 
Liedesdorf  saw  it  in  a  dog  scared  by  a  locomotive. 

A  strong  impression  like  that  caused  by  transition  from  bright 
light  into  darkness,  by  seeing  shadows  of  trees  crossing  the  road, 
or  violent  suffering  caused  by  severe  forms  of  constraint  have 
been  named  as  causes. 

Speaking  in  **  Brain,**  of  epilepsy  in  man,  Alexander  Haig  at- 
tributes the  fits  to  the  fluctuations  of  uric  acid  in  the  blood. 
Headache  (migraine)  he  finds  to  be  very  closely  allied  to  epi- 
lepsy and  convulsions  and  to  be  a  result  in  a  susceptible  system 


EpiUspy,     Falling  Sickness.  53 

of  a  liberal  flesh  diet.  By  a  vegetable  and  fruit  diet  he  reduces 
the  ingestion  and  formation  of  uric  acid,  so  that  the  largest 
quantity  which  a  patient  is  likely  to  get  into  his  blood,  shall 
never  or  only  very  rarely,  affect  the  blood  pressure  and  increase 
the  intra-cranial  circulation  to  a  dangerous  extent.  In  predis- 
posed subjects,  all  flesh  food,  soup,  and  meat  extracts  must  be 
avoided,  while  even  tea,  coffee,  cocoa  and  other  vegetable  arti- 
cles containing  zanthin  compounds  are  to  be  regarded  as  pro- 
ducing uric  acid,  and  to  be  denied,  or  employed  only  as  the 
merest  flavoring. 

This  position  is  greatly  strengthened  by  the  fact  that  epilepsy 
is  so  much  more  frequent  in  the  camivora  (dog,  cat,  bird)  than 
in  the  herbivora.  It  also  suggests  very  strongly  a  light  vege- 
table diet  for  both  prophylactic  and  curative  purposes  in  our 
domestic  animals.  In  the  same  line  the  frequent  and  liberal 
drinking  of  warm  water,  the  use  of  diuretics  and  the  flushing  of 
the  large  intestine  are  indicated. 

For  other  causes  see  under  pathology. 

Symptoms  in  the  Horse.  It  has  been  claimed  that  premoni- 
tory symptoms,  such  as  dullness,  lack  of  energy  and  quick,  ner- 
vous or  startled  movements  herald  an  attack,  but  in  animals  as 
in  man,  the  disease  usually  attacks  suddenly  without  any  ante- 
cedent indication. 

If  at  work  the  horse  stops  suddenly,  or  if  in  the  stable  he 
ceases  eating,  seems  frightened,  stands  for  an  instant  immovable, 
braces  his  feet,  sways,  trembles,  and  falls  heavily  to  the  ground. 
Or  he  may  remain  for  an  instant  supported  on  his  rigid  limbs, 
the  jaws  moving  or  firmly  closed,  the  eyes  rolling,  and  the  facial 
muscles  drawn  or  twitching.  When  down  there  are  convulsive 
movements  of  the  limbs,  so  that  the  animal  may  kick  out  violent- 
ly, and  tense  contractions  or  twitchings  may  occur  in  the  muscles 
of  the  croup,  chest  and  abdomen.  There  is  usually  an  increase 
of  the  salivary  secretion  with  frothy  accumulation  about  the 
angles  of  the  mouth.  The  respiration  is  stertorous,  dyspnoeic, 
and  interrupted,  the  nostrils  widely  dilated,  the  nasal  mucosa  of 
a  dark  brownish  red,  and  the  superficial  veins  distended.  The 
pulse  is  weak,  slow,  irregular,  intermittent  and  sometimes  im- 
perceptible.    Sensation  seems  to  be  in  abeyance.     No  attention 


54  Veterinary  Medicine, 

is  paid  to  loud  sounds,  nor  to  pinching,  pricking,  or  even  cauter- 
izing the  skin.  Perspirations  may  break  out  on  the  flank  or 
over  the  whole  surface  of  the  body. 

The  duration  of  the  attack  may  be  from  one  to  four  minutes, 
or  exceptionally  ten  or  fifteen,  after  which  the  muscles  relax,  the 
twitching  ceases,  the  horse  raises  his  head,  extends  his  fore 
limbs  and  finally  rises. 

After  rising  some  are  dull  and  stupid  for  an  hour  or  so,  and 
may  continue  to  perspire,  some  move  the  limbs,  jaws  or  head 
automatically,  turn  in  a  circle,  or  seek  seclusion  and  darkness, 
while  some  take  at  once  to  eating  and  seem  as  if  nothing  had 
happened. 

In  partial  or  localized  epilepsy  the  spasms  are  confined  to  a 
limited  groupof  muscles  like  those  of  the  jaws,  neck,  or  fore  limbs. 
These  may  alternately  contract  and  relax,  or  they  may  remain  rigid 
for  a  minute  or  less,  the  mouth  being  held  open  or  firmly  closed 
with  grinding  of  the  teeth,  the  eyes  rolled  backward  and  upward, 
or  affected  with  strabismus,  the  face  drawn  and  distorted,  the 
head  turned  to  one  side  or  downward,  or  the  limbs  fixed  and 
immovable. 

At  the  conclusion  of  an  attack  it  is  not  uncommon  to  see  a  dis- 
charge of  urine  or  faeces,  or  in  stallions,  of  semen. 

The  horse  often  contracts  a  fear  of  the  place  where  the  attack 
occurred,  and  this  contributes,  with  the  re-appearance  of  the 
former  object  of  dread  (car,  locomotive,  rifles,  cannon,  etc.)  to 
precipitate  a  new  attack  if  he  is  compelled  to  go  to  such  a  place. 

Symptoms  in  Cattle.  In  cattle  the  animal  is  attacked  without 
premonition,  bellows,  breathes  hard  and  with  effort,  has  dilata- 
tion of  the  nostrils,  and  squinting  or  rolling  upward  and  back- 
ward of  the  eyes  and  falls  to  the  ground  rigid  and  trembling. 
There  may  be  violent  succussions  of  the  limbs,  head  or  neck, 
movements  of  the  jaws,  grinding  of  the  teeth,  and  the  appearance 
of  frothy  saliva  and  elements  of  food  about  the  lips.  The  beats 
of  the  heart  are  violent,  the  pulse  slow  and  small,  and  sometimes 
intermittent.  Involuntary  micturition,  defecation,  or  discharge 
of  semen  may  occur.  In  slight  cases  one  or  more  of  these  symp- 
toms may  be  absent,  and  the  victim  may  not  even  fall  to  the 
ground  but  support  himself  against  a  wall  or  other  object. 


Epilepsy,     Falling  Sickness,  55 

The  duration  of  the  attack  may  be  from  one  to  five  minutes, 
rarely  more,  and  there  is  often  a  slow  and  progressive  subsidence 
of  the  spasms.  When  recovered  the  animal  may  get  up  and  go 
to  eating  or  rumination  as  in  health. 

Symptoms  in  Sheep.  In  sheep  the  attack  is  sudden.  The 
animal  ceases  eating  or  stops  in  its  walking,  and  after  turning  or 
other  voluntary  movement  falls  to  the  ground,  head  extended, 
mouth  open,  eyes  rolling  or  squinting,  and  with  rigidity  or 
twitching  of  the  muscles  of  the  neck  or  limbs.  There  is  the 
same  loss  of  sensation,  frothing  from  the  mouth,  and  grinding  of 
the  teeth  as  in  the  larger  animals.  The  attack  may  last  40  to  50 
seconds. 

Symptoms  in  Swine.  In  pigs  a  state  of  discomfort  and  rest- 
lessness often  marks  the  approach  of  an  attack,  referable  probably 
to  the  digestive  disturbance  or  to  parasites  which  furnish  the  oc- 
casion of  the  disease.  Uneasy,  wandering  movements,  jerkings 
of  head  or  limbs,  rolling  of  the  eyes,  champing  of  the  jaws 
may  first  appear.  Then  the  animal  falls,  extending  its  limbs 
and  head,  with  open  mouth,  retracted  lips,  and  a  free  flow  of 
saliva.  Trembling  and  jerking  of  the  head,  neck  and  limbs, 
hurried,  short,  difficult  breathing,  and  complete  loss  of  sensation 
may  be  noted.  Discharges  of  urine,  semen,  and  prostatic  fluid 
are  not  uncommon.  The  attack  usually  lasts  2  or  3  minutes, 
and  exceptionally  10  to  15.  In  the  shorter  seizures,  frequent 
repetition  is  not  uncommon,  Delafond  having  observed  5  or  6 
attacks  in  the  course  of  an  hour. 

Symptoms  in  Dogs.  The  attack  is  sudden  and  unheralded  by 
prodromata.  The  animal  stops,  trembles,  cries  plaintively  and 
falls  ;  he  may  manage  to  rise  or  to  do  so  in  part  but  instantly  falls 
anew.  The  limbs  stiffen,  tremble  or  twitch,  the  head  is  extended 
or  flexed,  or  jerked,  violently  striking  the  ground,  the  mouth 
open,  with  abundant  saliva,  or  firmly  closed  though  the  tongue 
may  be  between  the  teeth.  The  trunk  may  be  firm  and  rigid  or 
alternately  twisted  in  one  direction  or  the  other.  The  eyes  roll 
or  squint,  and  the  breathing  is  stertorous  and  difficult.  Insensi- 
bility is  complete.  Toward  the  end  of  the  attack  there  may  be 
a  discharge  of  urine,  faeces  or  semen,  the  stools  often  containing 
worms.  The  body  is  often  wet  with  perspiration  during  or  after 
an  attack. 


56  '         Veterinary  Medicine. 

The  attack  usually  lasts  for  two  or  three  minutes,  then  the 
convulsions  gradually  lessen  in  intensity  and  finally  cease,  the 
dog  raises  his  head,  opens  his  eyes,  and  gazes  inquiringly  around. 
Then  he  gets  on  his  feet,  shakes  himself  and  may  at  once  resume 
his  customary  habits.  In  other  cases  the  restoration  is  less  sud- 
den. The  dog  remains  for  30  to  60  minutes  dull  and  stupid,  or 
seems  to  have  little  power  of  control  over  its  muscles  and  stag- 
gers as  if  intoxicated,  or  as  if  the  muscles  were  benumbed.  It 
may  drop  on  its  knees  and  thien  fall  with  the  head  on  the  ground 
and  repeat  this  several  times.  In  other  cases  the  dog  wanders 
around,  or  trots  off  and  may  snap  at  any  one  interfering  with 
him,  so  that  the  case  is  often  mistaken  for  one  of  rabies.  Finally 
the  animal  may  remain  prostrate  and  fall  into  a  deep  sleep  marked 
by  stertorous  breathing. 

Diagnosis,  The  diagnosis  of  epilepsy  is  usually  easy.  The 
suddenness  of  the  attack,  the  loss  of  consciousness,  the  muscular 
spasms,  the  complete  temporary  recovery  and  the  tendency  to 
recur,  forma  toute  ensemble,  which  is  pathognomonic.  The  danger 
of  confounding  this  with  other  nervous  disorders  is  on  the  whole 
greatest  in  the  slight  cases  in  which  the  symptoms  are  less  tjrpical. 

From  Syncope  it  is  easily  distinguished  by  the  spasms  which 
are  not  present  in  syncope. 

From  eclampsia  it  is  not  so  easy  to  diagnose,  but  the  line  be- 
tween eclampsia  and  epilepsy  has  not  been  accurately  drawn, 
and  some  have  even  shown  a  disposition  to  drop  eclampsia  from 
medical  nomenclature.  Eclampsia  may  be  defined  as  general 
convulsions  dependent  on  some  eccentric  irritation,  and  which  do 
not  recur  after  such  irritation  has  been  removed.  This  would 
remove  from  the  category  of  epileptic  attacks  the  cases  of  convul- 
sions in  which  the  attacks  were  due  to  intestinal  or  nasal  parasites, 
dentition,  irritation,  tumors  pressing  oft  nerves,  canine  distemper 
and  other  infectious  diseases.  So  far  the  distinction  might  be 
made  by  the  diagnosis  of  the  particular  disease  on  which  the 
convulsions  depend.  There  remains  however  a  class  of  cases  in 
which  the  centric  nervous  disorder  on  which  the  epileptic  seizure 
depends  is  present,  and  also  the  peripheral  source  of  irritation 
(worms,  etc.).  In  such  a  case  the  presence  of  the  worms  or 
other  eccentric  source  of  irritation,  even  if  added  to  the  fact  that 
this  was  the  immediate  exciting  cause  of  the  epileptic  explosion. 


Epilepsy,     Falling  Sickness,  57 

could  not  do  away  with  the  fact  that  the  essential  conditions  of 
epilepsy  are  permanently  present  in  the  nervous  centres.  The 
difficulty  therefore  of  making  an  accurate  differential  diagnosis, 
resides  largely  in  the  impossibility  of  drawing  a  definite  line  of 
pathological  separation  between  eclampsia  and  epilepsy. 

From  Vertigo  epilepsy  is  distinguished  by  the  absence  in  the 
former  of  marked  spasmodic  contractions.  It  is  only  in  the  mild- 
er forms  of  epilepsy  those  in  which  the  spasmodic  action  is  so 
slight  as  to  be  overlooked,  that  this  disease  can  be  confounded 
with  vertigo. 

From  Thrombosis  or  embolism  of  the  iliac  or  femoral  arteries 
epilepsy  is  easily  distinguished  by  the  absence  of  exercise  as  the 
essential  cause  in  the  development  of  the  latter.  In  thrombosis 
on  the  other  hand,  the  loss  of  control  over  the  hind  limbs  is  de- 
veloped at  will  by  active  motion  (walking,  trotting).  In  throm- 
bosis too  the  absence  of  pulsation  at  the  fetlocks  or  at  any  point 
below  the  seat  of  obstruction  is  conclusive. 

Question  of  Soundness  and  Jurisprudence.  Manifestly  a 
horse  or  bull  subject  to  attacks  of  epilepsy  is  not  sound.  It  is 
moreover  a  disease,  the  symptoms  of  which  are  only  shown  for  a 
very  short  period  at  one  time,  after  a  long  interval  of  apparently 
perfect  health.  It  is,  therefore,  a  disease  against  which  a  purchas- 
er cannot  be  expected  to  protect  himself  and  he  should  have  the 
right  to  annul  the  sale  and  return  the  animal  in  case  the  infirmity 
should  appear  within  a  reasonable  period  after  purchase.  This 
is  provided  for  in  the  laws  of  different  countries  of  Europe,  thus 
in  Wurtenberg,  Baden  and  Hesse,  a  purchased  animal  may 
be  returned  within  28  days  ;  in  France  within  30  days,  and  in 
Bavaria  within  40  days.  The  greatest  difficulty  arises  from  the 
frequent  impossibility  of  obtaining  expert  testimony  on  a  seizure 
which  is  likely  to  occur  at  any  moment,  without  premonition, 
and  in  which  the  testimony  of  a  non-expert  may  easily  be  mis- 
leading. It  seems  as  if  complaint  having  been  made  within  the 
specified  legal  time,  an  extension  of  guarantee  should  be  given 
by  the  court,  the  animal  to  be  meanwhile  kept  under  the  super- 
vision of  a  veterinarian. 

Another  question  has  arisen  as  to  the  position  of  an  animal 
suffering  from  reflex  epilepsy.  If  the  attacks  are  caused  by  in- 
testinal worms  or  nasal  acarina  which  are  easily  removed,  it  is 


58  Veterinary  Medicine. 

quite  evident  that  this  cannot  be  considered  as  a  permanent  un- 
soundness, and  one  for  which  a  contract  of  sale  can  be  justly 
annulled.  But  on  the  other  hand,  while  the  eccentric  source  of 
irritation  which  is  easily  curable  may  have  been  the  active  agent 
in  developing  the  seizures,  it  may  be  none  the  less  true  that  the 
central  infirmity  which  determines  the  abnormal  susceptibility,  to 
excessive  generation  and  epileptic  explosion  of  nervous  force, 
may  also  be  present  and  the  animal  cannot  be  considered  as 
sound  until  a  sufficient  length  of  time  has  elapsed  after  the  re- 
moval of  the  peripheral  irritation  and  no  new  seizure  has  taken 
place. 

Treatment  of  Symptomatic  Epilepsy.  In  cases  due  to  an  ec- 
centric irritant  the  first  step  must  be  the  removal  of  such  irritant. 
In  case  of  intestinal  worms  the  various  vermicides  and  tseniacides 
must  be  resorted  to.  (See  Intestinal  Parasites).  For  the 
linguatula  taenioides  the  injection  of  benzine  or  tobacco  water 
into  the  nose,  or  into  the  sinuses,  with  or  without  trephining  may 
be  resorted  to.  In  diseased  teeth  extraction  or  filling  may  be 
demanded.  In  dentition-irritation,  lancing  of  the  gums.  In  all 
other  cases  in  which  a  peripheral  nervous  irritation  can  be  traced 
every  available  means  should  be  taken  to  remove  it. 

Treatment  of  Central  Epilepsy.  Bearing  in  mind  that  peri- 
pheral irritation  is  a  frequent  exciting  cause  of  a  seizure,  too 
much  care  cannot  be  given  to  the  conservation  of  the  general 
health  and  especially  to  make  the  diet  wholesome  in  quantity, 
quality  and  time  of  feeding  and  yiratering,  and  to  guard  against 
constipation  and  indigestion.  In  dogs  a  too  stimulating  meat 
diet  is  to  be  avoided. 

The  medicinal  agents  employed  have  been  mainly  such  as  are 
sedative,  or  tonic  to  the  ner\'ous  system.  Valerian  was  long  ex- 
tolled as  a  valuable  remedy  (Gohier,  Delafond,  Delwart),  and 
this  has  been  improved  upon  more  lately  by  substituting  valerian- 
ate of  zinc.  Belladonna  and  its  alkaloid  atropia  have  been 
strongl3'  advocated  (Tisserant,  Bernard,  Williams,  Friedberger) 
and  it  has  the  recommendation  that  it  causes  vaso-motor  contrac- 
tion and  tends  to  lessen  cerebral  congestion.  Hyoscine  or  du- 
boisine  may  be  used  as  a  substitute.  Cyanide  of  iron  has  been 
lauded  by  Jourdier  and  Tabourin,  as  far  superior  to  valerian.  Of 
late  years  the  nerve  tonics,  zinc  compounds  (oxide,  sulphate. 


Epilepsy,     Failing  Sickness,  59 

chloride)  and  silver  salts  (nitrate)  and  arsenic  have  been  used, 
often  with  excellent  results.  Borax  strongly  recommended  for 
man  ( i  to  i  J^  drachm  daily)  by  Pastena  is  worthy  of  a  trial  for 
dogs.  It  is  given  largely  diluted  in  syrup  to  avoid  gastric  irri- 
tation. 

Of  all  agents  employed  up  to  the  present  the  bromides  still 
claim  a  foremost  place.  They  should  be  given  in  a  large  dose, 
on  an  empty  stomach  and  at  such  a  time  as  to  occupy  the  system 
at  the  hour  when  the  seizure  is  exp^ted  to  recur.  Thus  for 
morning  attacks  the  dose  may  be  given  at  night,  while  for  night 
attacks  it  may  be  given  in  the  afternoon.  Miiller  uses  sodium 
bromide  in  the  dog  as  least  liable  to  disturb  the  stomach,  while 
Peterson  for  man,  advnses  the  potassium  salt  for  the  same  reason. 
For  man,  McLane  Hamilton  advocates  a  combination  of  the 
sodium  and  ammonium  salts,  Eulenberg  adds  the  potassium  com- 
pound, while  Berkley  uses  strontium  bromide,  and  Boumeville 
camphor  monobromide. 

Given  at  night  in  full  dose  (30  grs.  for  dog)  the  bromides  tend 
to  secure  a  quiet  sleep,  with  brain  rest  and  recuperation.  If 
beneficial  they  should  be  repeated  daily  until  a  cure  or  other  sign 
of  bromism  appears.  This  may  be  somewhat  checked  by  arsenic 
or  chloral  hydrate. 

Wesley  Mills  finds  potassium  iodide  useful  in  some  dogs  when 
bromides  fail.  Bromohydrate  is  advocated  by  Miiller. 
Plechsig  and  others  have  had  excellent  results  in  man  from  the 
opium  bromide  treatment.  Pull  doses  of  opium  given  three 
times  a  day  for  six  weeks,  when  they  are  replaced  by  full  doses 
of  bromides  four  times  a  day. 

Improvement  should  be  shown  in  the  shortening  of  the  con- 
vulsions and  the  lengthening  of  the  intervals  between  them. 
Should  the  bromides  fail  in  this,  resort  may  be  had  to  other  treat- 
ment. 

Toulouse,  Clark  and  others  find  that  privation  of  salt,  in  man, 
allows  the  bromine  salt  to  replace  the  chlorine  one  in  the  tissues, 
and  the  hydrobromic  acid  the  hydrochloric  in  the  gastric  juice, 
and  in  this  way  the  bromine  can  be  introduced  safely  in  larger 
amount  into  the  tissues  and  is  longer  retained,  though  given  in 
half  the  do$es. 


6o  Veterinary  Medicine, 

A  most  important  element  in  the  treatment  is  a  vegetable  diet 
with  or  without  milk,  to  obviate  excessive  production  of  uric  acid. 
Anything  which  will  disagree  and  produce  gastric  or  intestinal 
fermentations  with  toxins  must  be  carefully  guarded  against  and 
these  will  differ  in  different  individuals. 

Stallions  and  other  excitable  males,  and  females  may  often  be 
cured  by  castration.  Patients  should  be  very  carefully  guarded 
against  all  sources  or  excitement,  reports  of  guns,  sight  of  loco- 
motives or  automobiles,  waving  flags,  instrumental  music, 
sudden  exposure  to  sunshine  or  other  bright  light,  reflection 
from  water,  snow,  or  ice,  the  contrast  of  dark  shadows,  as  of 
trees,  alternating  with  bright  light,  etc.  Dogs,  becoming  ex- 
cited at  a  show,  may  have  a  convulsion  if  not  removed,  and 
much  more  so  in  presence  of  another  dog  in  a  fit. 

A  surgical  operation  often  places  the  disease  in  abeyance  for 
many  months,  but,  unless  in  the  case  of  the  removal  of  a  dis- 
eased organ  which  has  acted  as  a  factor,  this  is  not  permanent. 
Hence  in  man  transient  benefit  has  been  secured  from  operations 
on  the  eyes,  the  brain,  the  testicles,  the  ovaries,  etc.  In  local 
(Jacksonian)  epilepsy,  which  can  be  traced  to  a  definite  cortical 
area  in  the  brain,  the  trephining  of  the  skull  and  the  excision  of 
the  cortex  at  that  point,  has  given  temporary  relief,  with  a  local 
palsy,  but  too  often  the  irritation  from  the  resulting  cicatrix  has 
in  time  aroused  the  disorder  anew.  Even  independently  of  the 
removal  of  the  cortex,  the  trephining  has  been  successfully  re- 
sorted to,  by  savage  as  well  as  civilized  peoples,  securing  a  tem- 
porary relief.  Though  not  in  practice  in  veterinary  medicine  it 
seems  as  if  this  were  even  more  applicable  than  in  man.  It 
would  be  fully  justified  if  it  preserved  for  a  year  or  more  an 
animal  in  usefulness  which  must  otherwise  be  destroyed,  even  if 
the  disease  should  return  at  the  end  of  this  time. 

Plunge  or  douche  baths  (60°  to  70°  F.)  and  rubbing  dry  will 
often  tone  up  the  nervous  system,  and  a  course  of  bitters,  or  iron, 
or  both,  may  prove  valuable.  An  out-door  life  and  moderate 
muscular  exercise  are  important. 

During  a  convulsion  the  animal  should  be  freed  from  all 
harness,  halters,  girths,  etc.,  that  would  impair  respiration,  the 
jaws  must  be  kept  apart  with  a  cloth  to  prevent  biting  the  tongue, 
and  the  animal  held  with  head  and  neck  in  natural  position. 


Eclampsia,     Convulsions,     Spasms,  6i 

To  arrest  the  spasms  the  best  agent  is  amyle  nitrite  inhaled  from 
a  handkerchief.  It  may  be  replaced  by  a  mixture  in  equal  parts 
of  chloroform  and  ether.  Or  rectal  injections  may  be  given 
of  chloral.  Nitro-glycerine  will  sometimes  cut  short  an  attack  or 
prevent  it.  Small  animals  may  have  the  body  immersed  in  a 
warm  bath,  and  cold  applied  to  the  head.  Congested  buccal  and 
conjunctival  mucosae  would  indicate  cold  to  the  head,  while 
pallor  would  suggest  warm  fomentations. 

When  the  fit  is  over  the  animal  should  be  kept  in  a  quiet, 
dark  place  until  the  excitement  or  stupor  has  completely  passed. 


\ 


t. 


;  ECLAMPSIA.     CONVULSIONS.     SPASMS. 

Definition  :  functional  convulsions  from  peripheral  irritation.  Prom  den- 
tition, helminths,  uterine  disease,  nursing  (anaemia).  Treatment..  Injuries 
to  cranial  bone. 

Eclampsia  (convulsions)  is  difficult  to  define  as  distinct  from 
epilepsy,  the  present  tendency  however  appears  to  be  to  apply 
this  term  to  cases  in  which  the  spasms  are  of  a  purely 
functional  nature  as  far  as  the  brain  is  concerned  and 
caused  by  peripheral  nervous  irritation.  Whereas  in  epilepsy 
there  is  some  organic  disease  or  disorder  of  the  brain  itself. 
Therefore  the  convulsions  of  anaemia,  of  teething,  and  of 
parasitism,  would  come  under  this  heading  being  curable  by 
the  removal  of  the  distant  source  of  irritation,  while  the  spas- 
modic seizures,  that  are  due  to  central  nervous  lesions  and  are 
not  exclusively  dependent  on  peripheral  irritation  would  be 
classed  as  epilepsy.  In  other  words  reflex  epilepsies  with  no 
central  brain  disorganization  would  be  classed   as  convulsions. 

Eclampsia  from  Dentition  is  seen  especially  in  young  cats, 
dogs  and  pigs  when  cutting-teeth,  and  may  be  obviated  by 
lancing  the  gums,  extracting  diseased  or  milk  teeth  entangled  on 
the  crowns  of  their  successors,  and  by  a  slight  laxative  with 
bromides. 

Eclampsia  from  Helminthiasis  has  been  already  referred  to 
under  epilepsy.  The  main  object  is  the  expulsion  of  the  worms, 
after  which  nerve  sedatives  and  tonics  will  be  valuable. 


62  Veterinary  Medicine. 

Eclampsia  from  Uterine  Disease  has  been  noticed  by  Al- 
brecht,  in  cows  shortly  after  calving,  the  symptoms  being  spasms 
of  the  neck,  persistent  extension  or  turning  of  the  head,  grind- 
ing of  the  teeth,  loss  of  consciousness,  convulsive  movements  of 
the  legs,  rolling  of  the  eyes,  and  slow  recovery.  The  same 
symptoms  have  been  observed  in  goats  and  have  been  sup- 
posed to  depend  on  a  reflex  from  the  irritated  womb.  Another 
supposable  cause  is  the  absorption  of  toxic  products  from  the 
womb  and  vagina.  Manifestly  the  removal  of  the  after  birth 
and  the  disinfection  of  the  womb,  should  be  here  employed 
along  with  the  ordinary  nerve  sedatives. 

Eclampsia  in  Nursing  Female  Dogs  has  long  been  attributed 
to  anaemia  by  English  veterinarians.  It  occurs  especially  in  high 
bred  bitches,  when  nursing  a  large  litter  and  some  weeks  after 
parturition  when  the  puppies  have  grown  large  and  vigorous, 
with  proportionately  increased  demands  on  the  maternal  source  of 
supply.  The  dam  shows  an  emaciated  aspect,  with  restless  anx- 
ious eyes,  a  wearied  expression,  and  a  generally  exhausted  ap- 
pearance. There  is  weakness  and  swaying  behind,  or  complete 
inability  to  use  the  limbs,  the  animal  goes  down,  trembles  vio- 
lently and  shows  clonic  spasms  of  the  extensors  of  the  legs,  the 
neck,  the  back,  the  face  and  the  eye.  Breathing  is  accelerated, 
stertorous  and  labored,  the  heart  beats  violently,the  mucous  mem- 
branes are  congested,  and  the  mouth  is  opened  with  convulsive 
movements  of  the  jaws  and  throat.  The  attack  is  readily  dis- 
tinguished from  epilepsy,  by  the  retention  of  sensation,  and  by 
the  absence  of  involuntary  passages  from  the  bowels,  or  kidneys. 
Recovery  is  likely  to  be  secured  if  the  puppies  or  most  of  them 
are  removed  early  enough  and  the  bitch  sustained  by  nourishing 
food,  and  tonics.  The  spasms  may  be  combated  by  the  anti- 
spasmodics and  nerve  sedatives  employed  in  epilepsy.  Chloroform, 
morphia,  phenacetin,  acetanilid,  urethane  have  been  especially 
commended.  Beef  teas,  cod-liver  oil,  and  iron  may  be  resorted 
to  and  free  outdoor  exercise  and  sunshine  should  be  secured. 

General  convulsions  are  common  in  connection  with  direct  in- 
jury to  the  brain  and  more  particularly  of  its  coverings,  (cranial 
bones,  meninges).  In  such  cases  the  irritation  which  otherwise 
starts  at  a  distance  and  reaches  the  brain  through  the  afferent 
nerves,  or  the  modification  of  the  circulation  acts  directly  on  the 


Chorea,     St.    Vitus  Dance.  63 

gray  matter.  It  is  interesting  to  note  in  this  connection  that  the 
evacuation  of  the  cerebral  fluid,  which  removes  the  soft  support 
of  the  water  cushion  and  allows  the  brain  to  come  in  contact  with 
the  hard  bony  walls,  determines  an  access  of  convulsions.  In 
cases  of  convulsions  attendant  or  mechanical  injury  to  the  cra- 
nium surgical  interference  will  be  in  order. 


CHOREA.     ST.  VITUS  DANCE. 

Definition.  Snsceptible  animal.  Canaea:  nervona  leiaons  inconatant, 
youth,  debility,  anaemia,  microbian  toxins,  cerebral  embolism,  rhenmatiam, 
trophic  alterations  in  nerve  cells,  fright.  Lesions :  variable  in  seat  and 
character,  congestion  of  perforated  space,  corpns  striatum,  Sylvian  convolu- 
tions, gray  matter  at  root  of  posterior  horn  of  spinal  cord,  etc..  ezperi- 
menta  of  Chanveau  and  Wood.  Symptoms  :  dog,  local  twitching,  fore  limb, 
one  or  both,  neck,  head,  maxilla,  eyelida,  eyeballs,  hind  limbs,  trunk, 
rhythmic,  less  when  recumbent,  usually  absent  in  sleep,  roused  by  excite- 
ment ;  horse,  head,  neck,  fore  limb,  trunk :  cattle,  head,  neck,  limbs ; 
«wine,  hind  limbs,  neck,  head ;  severe  caaea  lead  to  exhaustion,  emaciation, 
marasmus,  paralysis.  Duration  :  weeks,  months,  years.  Treatment :  laxa- 
tive, tonic,  hygienic,  arsenic,  zinc  sulphate,  strychnia,  sedative,  belladonna, 
conium,  cannabia  Indica,  chloral,  acetanilid,  trional,  etc.,  icebags  or  ether 
•pray  to  spine,  cold  douches,  outdoor  life. 

Definition.  A  neurosis  characterized  by  constant  twitching  of 
muscles  or  of  groups  of  muscles,  and  which  usually  ceases  during 
sleep. 

Animals  Susceptible,  This  disease  is  especially  common  in  the 
dog,  but  has  been  recognized  also  in  the  horse,  ox,  cat  and  pig. 

Causes,  Much  diflFerence  of  opinion  exists  as  to  the  true  cause 
of  chorea.  In  many  cases  no  nervous  lesion  has  been  found  and 
therefore  the  disease  has  been  pronounced  purely  functional. 
The  victims  are  as  a  rule  the  young,  weak  and  debilitated  so  that 
anaemia  has  been  held  to  be  the  main  causative  factor.  Then  in 
dogs  the  affection  is  a  common  sequel  of  distemper  and  hence  it 
has  been  attributed  to  toxic  matters  (microbian,  etc. )  in  the  blood. 
It  should  be  added  that  European  writers  attribute  the  rhythmic 
spasms  which  follow  distemper  to  eclampsia,  epilepsy  or  tic,  and 
claim  that  the  contractions  must  be  irregular  orarhythmic  in  order 


64  Veterinary  Medicine, 

to  constitute  chorea.  English  and  American  writers,  however, 
have  attributed  less  importance  to  this  point  and  consider  that 
the  constancy  and  persistency  of  the  contractions  in  the  dog, 
differentiate  an  affection  from  both  eclampsia  and  the  epilepsy  and 
relate  it  rather  to  chorea.  Tic  as  illustrated  in  crib-biting  is  cer- 
tainly not  constant  nor  rhythmical  nor  is  it  a  habit  beyond  the 
control  of  the  will. 

Among  other  alleged  causes  of  chorea  is  embolism  of  the  ar- 
teries of  the  brain  or  spinal  cord.  Angel  Money  went  so  far  as 
to  inject  a  fluid  containing  arrowroot,  starch  granules  and  car- 
mine into  the  carotids  of  animals,  and  produced  movements 
closely  resembling  those  of  chorea.  Another  theory  connects 
chorea  with  the  rheumatic  poisons.  Some  English  writers  find 
more  than  80  per  cent,  of  all  cases  in  man  associated  in  someway 
with  rheumatism,  but  in  Philadelphia,  Sinkler  found  that  not  more 
than  15  per  cent,  showed  such  a  relation.  D.  C.  Wood  as  the 
result  of  necropsies  of  a  number  of  choreic  dogs  reached  this 
conclusion :  * '  Owing  to  emotional  disturbance,  sometimes  stopping 
of  various  vessels  of  the  brain,  or  sometimes  the  presence  of 
organic  disease,  there  is  an  altered  condition  of  the  ganglionic 
cells  throughout  the  nerve  centres.  If  the  cause  is  removed  and 
the  altered  condition  of  the  nerve  cells  goes  only  so  far,  it  re- 
mains what  we  call  a  functional  disease.  If  it  goes  so  far  that 
the  cells  show  alteration,  we  have  an  organic  disease  of  the 
nervous  system.  ** 

In  man  the  element  of  sudden  fright  is  awarded  a  high  position 
in  the  list  of  causes. 

Lesions,  Constant  morbid  changes  of  structure  have  not  been 
established  in  chorea.  On  the  contrary  in  the  many  careful  ne- 
cropsies of  choreic  subjects  some  lesions  of  brain  or  spinal  cord 
has  been  almost  always  found.  Dickinson  always  found  con- 
gestion of  some  part  of  the  brain  or  spinal  cord,  but  most  con- 
stantly of  the  substantia  perforata,  the  corpora  striata  and  the 
beginning  of  the  Sylvian  fissure.  In  the  cord  the  cervical  and 
dorsal  regions  were  the  most  commonly  affected,  and  preeminently 
the  gray  matter  at  the  root  of  the  posterior  horn.  The  bilateral 
symmetry  of  the  contractions  in  cases  of  unilateral  lesions,  has 
been  held  to  discredit  the  theory  of  embolic  origin,  yet  this  may 


Chorea.     St,  Vitus  Dance,  65 

be  explained  by  mutual  relation  of  the  ganglia  of  the  two  sides 
and  their  coordination  of  function. 

The  question  of  the  relative  importance  of  the  encephalic  and 
spinal  lesions  has  been  also  debated.  Chauveau  believed  that  by 
section  of  the  cord  in  choreic  dogs,  he  had  proved  that  the  spasms 
were  of  medullary  origin.  Wood  on  the  other  hand  found  that 
the  choreic  movements  persisted  after  section  of  the  cord,  and 
seemed  warranted  in  the  conclusion  that  the  movements  origin- 
ated in  the  cord.  The  probability  is,  that  with  the  cord  intact, 
the  primary  source  of  the  morbid  movement  may  reside  either  in 
the  encephalon  or  the  cord.  In  chorea,  following  distemper,  I 
have  found  marked  congestion  of  the  encephalon  and  its  men- 
inges. 

Symptoms,  In  the  dog  the  twitching  may  be  confined  to  one 
fore  leg,  or  it  may  extend  to  both  and  then  usually  implicates  the 
neck  and  head.  In  other  cases  the  lower  jaw,  the  head,  the  eye- 
lids or  even  the  eyeballs  may  be  the  seat  of  the  twitching  motions 
and  in  still  others  the  hind  limbs  and  trunk  are  also  implicated. 
In  nearly  all  cases  the  tendency  is  to  a  continuous  rhythmic 
action,  which  may  moderate  without  actually  ceasing  while 
the  animal  lies  down,  but  which  usually  stops  altogether  during 
deep  sleep.  When  it  intermits  at  other  times  it  can  commonly 
be  roused  into  activity  by  exciting  the  animal  in  any  way. 

In  the  horse  the  muscles  affected  may  be  those  of  the  head 
and  neck,  of  the  fore  limb  (Hering),  of  head,  limbs  and  trunk 
(Leblanc). 

In  cattle  the  movements  have  affected  the  neck  and  head  and 
the  fore  or  hind  limbs  (Anacker,  Schleg). 

In  young  pigs  the  hind  limbs,  the  neck  and  head  have  been 
chiefly  involved  in  the  spasms  (Hess,  Vervey). 

If  the  affection  is  slight  it  may  not  seriously  impair  the  general 
health,  but  in  proportion  to  its  severity  and  the  constancy  and 
generalization  of  the  spasms  and  the  consequent  muscular  waste 
and  exhaustion,  the  animal  becomes  gradually  worn  out  and 
emaciated  and  dies  of  paralysis  and  marasmus. 

Duration,     In  favorable  cases  recovery  may  ensue  in  a  few 
weeks ;  in  others  the  disease  becomes  chronic  and  will  last  for 
months  or  years. 
5 


66  Veterinary  Medicine. 

Treatment.  Among  the  first  indications  are  fresh  air  and 
wholesome  easily  digestible  food.  The  removal  of  any  source  of 
intestinal  irritation  should  be  sought  by  bland  laxatives.  As 
the  health  is  usually  low,  a  course  of  iron  tonics  is  nearly  always 
in  order. 

Special  nervous  tonics  are  next  demanded.  No  agent  has  a 
better  reputation  than  arsenious  acid.  Ten  drops  of  a  i  per  cent, 
solution  of  arsenite  of  soda  may  be  given  daily  to  the  dog  or  one 
ounce  to  the  horse.  If  gastric  irritation  forbids  the  use  of  this 
agent,  sulphate  of  zinc  may  be  given  in  i  to  3  grain  doses  twice 
a  day  to  the  dog.  In  other  cases  strychnine  i^  to  ^  oi  a  grain 
may  be  given  in  the  same  manner. 

Nerve  sedatives  often  have  a  good  efiFect  in  calming  the  nerv- 
ous irritability  and  in  this  way  belladonna,  conium,  canabis 
Indica,  chloral,  chloroform,  acetanilid,  triohal,  etc.,  have  been 
employed. 

In  the  same  line  are  ice  bags  or  ether  spray  applied  to 
the  spine  for  ten  minutes  at  a  time,  and  douche  baths  of  cold 
water,  the  animal  being  afterward  rubbed  dry.  This  last  par- 
takes of  the  nature  of  a  stimulant  and  may  be  classed  with  gentle 
exercise  which  at  once  distracts  the  patients'  attention  from  the 
nervous  infirmity,  trains  him  to  control  the  muscles,  gives  nor- 
mal exercise  and  tone  to  the  enfeebled  organs  and  improves  the 
general  health. 


CONVULSIVE  TWITCHING  OF  THE  FACE. 

Nature  of  phenomenon,  arhythmic,  hyperezcitability  of  nerve  centres  or 
•kin.  Nerve  section.  Head  jerking :  horse,  hard  bit,  severe  check,  inter- 
nal pain,  exertion,  hypersensitiveness.  Treatment :  nerve  section.  Tongue 
lolling,  etc.  Flapping  of  lower  lip.  Nasal  rhythmic  movements.  Weav- 
ing, from  impatience,  rhythmic.  Rocking  on  hind  limbs.  Resting  foot  on 
coronet.  Pawing.  Treatment :  eliminate  irritation,  nerve  tonics,  sedatives, 
hygienic  meabures. 

This  has  been  observed  especially  in  the  dog  and  may  be 
easily  confounded  with  chorea.  The  muscles  on  one  side  of  the 
face  are  twitched  at  more  or  less  regular  intervals,  or  in  other 
cases  there  are  sudden  opening  and  closing  of  the  lower  jaw. 


Convulsive  Twitching  of  the  Face.  67 

The  a£Fection  has  not  been  satisfactorily  connected  with  any 
special  brain  lesion,  though  as  in  chorea  proper  and  epilepsy,  we 
must  invoke  a  special  disorder  or  hyper-excitability  of  the  nerve 
centres  presiding  over  the  afiPected  muscles.  The  clonic  spasm 
may  in  some  cases  be  due  only  to  a  motor  impulse  from  such  ex- 
cited nerve  centre,  while  in  others  it  may  be  traced  backward 
along  the  afferent  nerves  to  an  oversensitive  part  of  the  skin  or 
other  organ.  In  these  last  purely  reflex  forms  of  the  trouble  it 
may  be  possible  to  correct  it  by  section  of  the  sensory  nerves 
involved. 

Convulsive  Movements  of  the  Head. 

Convulsive  movements  of  the  head  as  a  whole  constitute  a  fre- 
quent form  of  chorea  in  the  dog.  It  is  especially  common  in 
horses  and  shows  itself  in  different  forms.  A  horse  with  a 
tender  mouth,  or  which  has  been  used  with  a  hard  bit,  or  with  a 
heavy  hand  on  the  reins,  or  which  has  been  driven  with  a  check 
rein  so  short  as  to  be  unsuited  to  its  conformation,  is  liable  to  in- 
dulge in  annoying  elevation  and  depression  of  the  head  when 
under  the  saddle  or  in  harness.  The  same  phenomenon  may  be 
shown  in  connection  with  violent  internal  pains,  as  in  strangu- 
lated hernia,  intussception,  or  twisting  of  the  bowels.  The 
habit  once  formed  is  not  easily  corrected,  so  that  careful  treat- 
ment with  the  view  of  prevention  is  especially  to  be  given. 

Another  more  objectionable,  dangerous,  and  less  voluntary 
motion  is  the  sudden  jerking  of  the  head  upward,  or  to  one  side 
when  excited  under  the  saddle  or  in  harness.  The  disorderly 
movements  are  not,  as  a  rule,  seen  while  the  animal  is  at  rest, 
but  seem  to  be  produced  under  the  stimulus  of  exertion.  They 
appear  to  be  quite  involuntary,  and  suggest  the  dread  caused  by 
the  settling  or  buzzing  of  an  insect  about  the  nose  or  ears,  but 
occur  in  the  depth  of  winter  in  the  absence  of  insect  life,  as  well 
as  in  midsummer.  The  suddenness  and  involuntary  nature  of 
the  movement  is  suggestive  of  epilepsy,  but  there  is  no  indica- 
tion of  attendant  unconsciousness.  Prom  choreic  movements  it 
is  apparently  distinguished,  by  its  presence  only  when  ridden  or 
driven.  It  is  unquestionably  associated  with  hypersensitiveness 
of  the  nerve  centres,  and  yet  in  many  cases  it  appears  to  be  a 
reflex  originating  in  a  specially  tender  or  sensitive  part  of  the 


68  Veterinary  Medicine. 

skin  or  mucous  membrane.  In  more  than  one  instance  in  this 
college  clinic  the  trouble  was  corrected  by  the  section  of  both 
facial  branches  of  the  5th  cranial  nerves  as  they  emerged  from 
the  infra-orbital  foramina. 

Abnormal  Movements  of  the  Tongue. 

Some  horses  double  the  tongue^  downward,  others  upward  of 
the  bit ;  others  protrude  the  tongue  and  give  it  a  sinuous,  ser- 
pentine motion  which  causes  alternate  protrusion  and  retraction. 

Flapping  of  the  Lower  Lip. 

This  habit  of  rapid  opening  and  closing  of  the  lower  lip  so  as 
to  produce  a  disagreeable  flapping  noise  by  striking  it  against 
the  upper,  is  seen  in  many  horses  and  proves,  a  most  objection- 
able trait  in  harness  or  saddle  animals. 

Rhythmical  Movements  of  the  Nose. 

Certain  horses  apply  the  protractile  end  of  the  nose  against  the 
lower  lip  and  spend  hours  in  succession  in  moving  it  rhythmic- 
ally forward  and  backward,  or  from  side  to  side. 

Weaving.     Movement  like  a  Bear  in  a  Cage. 

This  consists  in  a  lateral  rocking  of  the  head  and  neck,  and 
sometimes  of  the  chest  as  well  with  alternate  stepping  on  the 
right  and  left  fore  feet.  It  has  been  supposed  to  represent  the 
movement  of  the  weaver  in  working  a  hand  loom,  or  still  better 
the  movement  of  a  caged  wild  beast  in  constant  turning  toward 
the  right  and  left  of  the  front  of  his  cage.  The  motions  are  as 
regular  as  a  pendulum,  and  'involve  the  contraction  of  corre- 
sponding groups  of  muscles  on  the  two  sides  of  the  body. 

They  seem,  in  some  cases,  to  begin  in  impatience  in  waiting 
for  the  feed,  while  other  horses  in  the  same  row  are  being  at- 
tended to  first,  but  when  the  habit  has  been  formed  it  may  be 
continued  most  of  the  time  in  the  intervals  between  feeds  as  well. 
Nervous  horses  and  those  that  are  hearty  feeders  are  the  most 
subject  to  this  infirmity. 


Vertigo.     Megrims.     Blind  Staggers.  69 

Disorderly  Movements  of  the  Limbs. 

Some  horses  have  a  habit  of  continuously  raising  one  hind 
limb,  others  raise  the  right  and  left  alternately,  rocking  the  hind 
quarters  from  side  to  side,  others  stand  with  the  heel  of  one  hind 
foot  resting  on  the  front  of  the  coronet  of  the  other,  while  still 
others  paw  continuously  with  the  fore  feet  while  standing  in  the 
stall. 

treatment.  These  various  conditions  even  when  begun  as  an 
expression  of  impatience,  soon  become  fixed  habits,  that  prove  in 
the  end  virtually  uncontrollable  by  an  animal,  which  has  no 
strong  will  and  no  consciousness  of  anything  to  be  gained  by  re- 
sisting the  impulse.  They  become  virtual  psychoses.  In  cases 
in  which  the  habit  can  be  traced  to  a  peripheral  irritation,  the 
cutting  o£F  of  this  by  complete  section  of  the  a£Ferent  ner\*es 
leading  to  the  irritable  nerve  centre  will  sometimes  succeed  in  ef- 
fecting a  cure.  In  other  cases  in  which  the  source  of  the  dis- 
order is  probably  largely  central  in  the  cerebral  ganglia,  ner\'e 
tonics,  and  sedatives,  and  generally  corroborative  treatment  are 
the  most  obvious  means  of  palliation.  Such  measures  are,  how- 
ever, rarely  successful.  Nourishing  food  and  invigorating  out- 
door exercise  are  useful  auxiliaries. 


VERTIGO.     MEGRIMS.     BLIND  STAGGERS. 

Disadnintage  of  lack  of  subjective  sjrmptoms.  Canaea,  varied,  narootica, 
overloaded  stomach,  cerebral  anemia  or  hypersemta,  degeneration,  parasites, 
tumors,  jugular  obstruction,  valvular  heart  disease,  disease  of  internal  ear, 
plethora.  Susceptible  animals :  horse,  oz,  dog,  pig,  sheep  Direct  causes : 
tight  collar,  or  throat-latch,  flexion  of  head,  heart  desease,  pulmonary  disease, 
embolisms,  gastric  distention,  hepatic  disorder,  optic  vertigo,  aural  vertigo, 
injections  into  ear,  rhigolene,  chloral,  acariasis,  seasickness,  railroad  sick- 
ness, cholesteatoma,  coenurus,  concussion,  degeneration,  softening,  oestrus, 
lingnatula,  narcotics,  essential  oils,  essential  vettigo.  Symptoms:  in  irrit- 
able animal,  highly  fed,  and  without  exercise,  crowds  pole,  his  mate  or  a 
wall,  shakes  or  jerks  head,  staggers,  trembles,  rears,  plunges,  falls,  struggles, 
sweats,  rolls  eyes,  recovers.  In  gastric  or  hepatic  cases,  dullness,  pendent 
head,  swaying  gait,  dull  eye,  dilated  pupil,  pendent  lids  and  lips,  leans  on 
adjacent  object,  staggers,  falls.  In  optic  cases  are  obvious  causes  in  transi- 
tion to  light,  etc.,  and  palliation  by  covering  the  eyes.    In  aural  cases,  roll- 


70  Veterinary  Medicine. 

ing  eyes,  constrained  position  of  ear,  deafness,  pharyngeal  or  Eustachian 
tronbl^,  wax  or  acari  in  ear,  tender  or  itchy  ear.  Plethoric  cases  in  spring, 
in  overfed,  etc.  Brain  lesions  may  have  fever  and  disordered  innervation, 
bnt  retained  consciousness,  and  no  marked  spasm.  Duration.  Sheep  :  para- 
sitic vertigo.  Turning.  Rotation.  Treatment  according  to  cause :  restrict 
ration,  give  exercise,  purgative,  adjust  collar,  breast  strap,  check,  avoid 
sudden  transitions  of  light,  overdraw  check,  blinds ;  treat  nasal,  pharangeal, 
ocular  or  aural  trouble ;  during  attack,  stop  in  shade,  cold  to  head,  deplete, 
bleed,  purge,  shady  pasture  or  light  work,  bromides,  blisters,  etc. 

In  dealing  with  vertigo  or  giddiness  in  animals  we  are  con- 
fronted by  the  impossibility  of  realizing  the  subjective  feelings 
of  the  animal,  as  we  can  so  easily  ascertain  by  interrogation  in 
the  case  of  man,  and  thus  our  conclusions  are  largely  inferences 
drawn  from  certain  unsteady,  reckless  or  uncontrollable  move- 
ments, or  from  an  apparent  inability  to  maintain  a  stable  equi- 
librium. The  condition  is  rather  a  symptom  of  a  variety  of 
morbid  conditions,  functional  and  structural,  than  a  disease 
sui  generis.  It  may  be  due  to  alcoholic  or  other  narcotic  intoxi- 
cation, to  an  overloaded  or  otherwise  deranged  stomach,  to  shock, 
to  a  stroke  of  lightning,  to  disturbances — ^anaemic  or  hypersemic — 
in  the  circulation  in  the  encephalon,  to  degenerations,  parasites 
or  tumors  in  the  brain,  to  compression  of  the  jugular  veins,  to 
valvular  or  other  disease  of  the  heart,  to  disease  of  the  internal 
ear,  to  the  plethora  of  spring  or  early  summer,  to  the  qualms  of 
sea  sickness,  to  insolation. 

The  purely  toxic  cases  are  more  clearly  defined  and  temporary 
so  that  they  may  be  eliminated  from  consideration  at  present,  yet 
their  possible  occurrence  must  always  be  borne  in  mind  by  the 
practitioner  especially  when  called  to  pronounce  upon  cases  of 
vertigo  in  connection  with  veterinary  legal  questions.  The 
cases  that  are  due  to  a  persistent  neurosis,  or  to  circulatory  troubles 
may  well  be  placed  in  a  list  by  themselves,  yet  in  their  legal  re- 
lations it  is  highly  important  that  the  practitioner  should  as  far 
as  possible  discriminate  among  these  as  well. 

Susceptible  Animals.  Vertigo  undoubtedly  exists  among  all 
domestic  animals.  The  symptoms  by  which  it  is  recognized 
have  been  noted  especially  in  the  horse  and  much  less  frequently 
in  ox,  dog,  pig  and  sheep. 


Vertigo.     Megrims,     Blind  Staggers,  ji 

Among  horses  it  especially  attacks  the  mature  or  aged,  and 
family  harness  horses,  pampered  and  irregularly  exercised  ;  (sad- 
dle horses  rarely  suffer)  ;  it  is  more  likely  to  appear  for  the  first 
time  in  spring  though  when  established  it  happens  at  all  seasons  ; 
it  may  come  on  when  a  horse  is  driven  in  blinders  and  fail  to  ap- 
pear in  the  absence  of  these. 

Causes,  ist.  Compression  of  the  jugular  veins  by  a  too  tight 
collar  is  the  cause  of  one  of  the  simplest  forms  of  vertigo  and  is 
observed,  in  growing  or  fattening  animals  in  which  the  neck  has 
become  gradually  too  large  for  the  collar.  The  supply  of  a  larger 
and  well  fitting  collar  will  soon  confirm  the  diagnosis  by  a  com- 
plete and  permanent  removal  of  the  trouble.  In  other  cases  the 
veins  may  be  compressed  by  undue  flexion  of  the  head,  the  chin 
being  drawn  toward  the  breast,  or  by  a  throat  latch  buckled  too 
tightly.  The  substitution  of  an  overdraw  check  rein,  or  a  loose 
throat  latch  will  show  the  true  source  of  the  trouble. 

2nd.  Disease  of  the  valves  of  the  heart  or  their  insufficiency 
from  cardiac  dilatation  is  a  common  cause  of  vertigo,  and  may  be 
recognized  by  auscultation  and  by  the  general  S3anptoms  of 
chronic  heart  disease. 

3d.  Disease  of  the  lungs  interfering  with  the  flow  of  blood 
through  the  right  heart  and  more  distantly  with  the  return  of 
bipod  from  the  brain.  It  further  effects  the  brain  functions 
through  the  circulation  of  a  highly  carbonized  blood,  which  fails 
to  maintain  the  normal  functions  of  the  ganglia. 

4th.  Disease  of  the  blood  vessels,  it  may  be  by  emboli 
washed  on  from  clots  in  the  pulmonary  veins  or  the  left  heart 
and  arrested  in  the  vessels  of  the  brain  ;  it  may  be  by  aneurism 
of  the  anterior  aorta  as  reported  of  a  horse  (Lustig)  ;  it  may  be  by 
phlebitis  and  thrombosis  of  the  jugulars  ;  it  may  be  by  adjacent 
tumors  pressing  on  the  vessels. 

5th.  Gastric  Vertigo,  Abdominal  Vertigo,  is  a  comj>lica- 
tion  of  gastric  or  hepatic  disorder  with  giddiness  and  unsteady 
movement.  The  abdominal  disorder  may  be  at  once  a  cause  and 
result  of  the  vertigo  and  it  is  not  always  easy  to  decide  which 
predominates.  The  unsteady  movements  in  certain  cases  of  over- 
loaded stomach  in  the  horse  are  illustrations  of  purely  abdomi- 
nal vertigo,  while  on  the  other  hand  in  vomiting  animals  nausea, 
retching,  emesis,  and  other  gastric  disorders  promptly  attend  on 


72  Veterinary  Medicine, 

the  primary  cerebral  disorder.  There  is  also  a  special  tendency 
to  vertigo  in  the  fat,  idle,  gorged  horse  and  in  those  with  torpor 
or  other  disorder  of  the  liver  occurring  in  pampered  horses  in 
spring  and  early  summer. 

6th.  Optic  vertigo  is  a  reflex  disorder,  determined  in  the  ex- 
citable nerve  centres  by  the  visual  influence.  Thus  it  has  been 
seen  in  horses  and  sheep  from  the  intense  glare  of  the  sun's  rays, 
reflected  from  a  lake  or  river  or  from  white  snow  or  ice,  or  even 
from  the  glistening  inner  surface  of  the  blinds.  The  effect  is  in- 
tensified if  the  animal  has  just  emerged  from  a  dark  stable  or  a 
darker  mine.  The  overdraw  check  may  be  a  factor  by  reason  of  its 
turning  the  eyes  upward  and  exposing  them  continuously  to  the 
full  glare  of  the  sun.  The  sense  of  motion  conveyed  through  the 
eyes  contributes  to  bring  on  giddiness  and  a  sense  of  swimming. 
In  man  this  is  notorious,  the  sense  of  nausea  and  vertigo  being 
precipitated  by  looking  at  the  nearby,  moving  objects  in  cabin 
or  on  deck,  while  it  may  be  retarded  by  directing  the  eyes  to 
steady  distant  objects.  As  dogs,  horses  and  other  animals  suffer 
from  seasickness,  and  even  railroad  sickness,  this  attendant  fac- 
tor may  be  logically  accepted.  The  mere  limitation  of  the  field 
of  vision,  by  the  use  of  blinds,  and  the  disappearance  in  rapid 
succession  of  near  objects  behind  this  narrow  screen  probably  has 
an  influence  similar  to  the  visible  motions  in  the  ship  between 
decks,  in  cases  in  which  these  portions  of  the  harness  are  mani- 
fest factors. 

7th.  Aural  Vertigo  is  determined  by  irritations  of  different 
kinds  affecting  the  external,  middle  or  internal  ear.  Experi- 
mental sections  show  that  this  is  especially  due  to  injuries  of  the 
semicircular  canals.  If  the  horizontal  canal  is  divided  there  are 
pendulum-like  movements  of  the  head  alternately  to  the  right 
and  left,  also  lateral  rolling  of  the  eyes.  If  Xh^  posterior  canal  is 
cut  there  is  a  vertical  movement,  or  nodding  of  the  head  and 
vertical  rolling  of  the  eyes.  If  the  superior  vertical  canals  are 
injured  there  are  pendulum-like  vertical  movements  of  the  head 
and  the  animal  tends  to  fall  forward.  Injury  to  the  anterior 
canal  causes  diagonal  rolling  of  the  eyeball.  In  destruction  of 
all  the  canals  various  pendulum-like  movements  are  performed, 
and  standing  often  becomes  impossible.  Stimulation  of  one 
auditory  nerve  is  followed  by  rotation  of  the  eye  and  rotation 


VerHgo.     Megrims,     Blind  Staggers  73 

of  the  body  on  its  axis  toward  the  injured  side.  The  passage  of 
a  galvanic  current  through  the  head  between  the  mastoid  pro- 
cesseSy  or  from  one  external  auditory  meatus  to  the  other  ^  causes 
rolling  of  the  eyeballs.  Injection  of  water  violently  into  a  rabbiVs 
ear,  or  of  iced  water  or  of  a  rhigolene  jet,  causes  rolling  of  the 
eyes,  and  rotation  of  the  body  toward  the  side  operated  on.  Dr. 
Wier  Mitchell  had  a  similar  experience  in  his  own  person.  If 
the  injections  are  repeated  a  permanent  vertiginous  condition  is 
induced,  and  the  rabbit  or  Guinea  pig,  which  has  been  kept 
in  darkness  for  a  few  hours  and  is  then  suddenly  exposed  to  sun- 
light, is  unstable  on  its  limbs  for  a  few  seconds.  Lucae  found 
that  with  perforation  of  the  membrana  tympani,  an  ear  air 
douche y  at  o.i  atmospheres  caused  abduction  of  the  eyeball, 
dyplopia,  giddiness,  sense  of  darkness,  and  disturbed  respiration. 
Vulpain  found  that  a  25  per  cent,  solution  of  chloral  hydrate 
dropped  into  the  ear  of  a  rabbit  caused  vertiginous  movements. 
McVey  records  the  case  of  a  music  teacher  who  had  intense  ver- 
tigo induced  by  the  law  bass  notes  of  a  piano.  Crum  Brown 
noticed  that  if  a  person  with  bandaged  eyes,  is  rotated  for  some 
time  as  on  a  potter's  wheel,  he  can  at  first  estimate  the  degree  of 
rotation,  but  after  a  time  he  fails  to  do  so,  and  the  rotation  may 
be  stopped,  without  checking  his  sense  of  whirling.  The 
familiar  method  of  subduing  an  intractable  or  vicious  horse  by 
running  him  rapidly  around  in  a  very  narrow  circular  course, 
or  by  tying  head  and  tail  together  and  letting  him  circle  around 
until  he  staggers  or  falls,  is  another  manifest  example  of  this 
aural  vertigo.  Rabbits  and  dogs  sufiFering  from  acaria^is  of  the 
external  ear  move  around  in  a  circle,  or  even  turn  somersaults 
tending  toward  the  affected  side.  Trasbot  has  found  larvae  of 
insects  (simulium  cinereum  ?)  in  the  ears  of  vertiginous  horses, 
which  he  successfully  treated  with  injection  of  chloroform.  Even 
hard  pellets  of  wax  pressing  on  the  tympanic  membrane  have 
been  found  to  give  rise  to  vertigo. 

The  explanation  of  cases  of  aural  vertigo,  has  been  sought  in 
the  physiological  action  of  the  endolymph  and  perilymph  on  the 
end  filaments  of  the  nerve  in  the  membranous  labyrinth,  the 
turning  of  the  head  from  one  side  to  the  other  having  the  effect 
of  changing  the  pressure  in  different  parts  and  establishing  cur- 
rents by  which  the  change  of  position  is  recognized ;    on  the 


74  Veterinary  Medicine. 

other  hand  any  injury  to  the  canals,  by  disturbing  the  pressure 
of  the  perilymph  and  interfering  with  the  relative  position  of  the 
canals,  and  the  direction  and  force  of  the  currents  of  the  endo- 
lymph  and  perilymph,  destroys  all  proper  sense  of  balance. 
The  rotation  of  the  subject  as  on  a  wheel  or  in  turning  in  a 
narrow  circle,  is  held  to  cause  circular  currents  in  and  around 
the  membranous  labyrinth  which  temporarily  destroy  all  sense  of 
equilibrium.  Seasickness  and  railroad  sickness  are  doubtless  in 
part  due  to  the  swaying  motions  causing  disturbance  in  the 
canals.  The  intimate  relation  between  the  root  of  the  auditory 
nerve  and  that  of  the  vagus  in  the  medulla,  may  serve  to  explain 
the  mutual  interdependence  of  derangement  of  the  stomach  and 
liver  on  the  one  hand  and  the  occurrence  of  vertigo  on  the  other. 
Again  the  relation  of  vertigo  to  visual  troubles,  both  as  to  cause 
and  effect,  has  been  attributed  to  the  close  relations  of  the 
ganglia  presiding  oyer  the  3d,  4th,  5th  and  6th  nerves  and  those 
of  the  nerve  of  hearing. 

There  is  a  degree  of  deafness  in  nearly  all  cases  of  aural  verti- 
go, a  circumstance  which  may  be  utilized  in  the  diagnosis  of  such 
cases,  the  presence  of  disease  of  the  guttural  pouch,  or  Eusta- 
chian tube,  and  evidence  of  deafness  on  one  side,  rather  than  the 
other,  may  be  taken  as  corroborative  evidence  of  the  affection. 
On  the  other  hand  James  shows  that  the  stone  deaf  are  much 
less  subject  to  both  seasickness  and  vertigo  than  those  that  hear. 
The  disorder  that  leads  to  vertigo  implies  a  retention  of  a  meas- 
ure of  the  normal  function  of  the  internal  ear,  and  therefore  of 
hearing,  whereas  the  disease  that  has  caused  complete  destruction 
of  the  internal  ear  and  consequent  loss  of  hearing  has  equally 
destroyed  the  function  of  the  labyrinth  in  maintaining  a  sense  of 
balance,  and  has  obviated  the  aural  sensations  of  equilibrium  and 
loss  of  balance. 

8th.  Cerebral  Vertigo  may  be  associated  with  derangement 
of  the  circulation,  or  disease  in  the  brain  or  its  meninges. 
Anaemias  and  congestions  resulting  from  disease  or  impaired 
function  of  heart,  lungs,  arteries  or  veins  have  been  already 
noticed.  It  remains  to  note  the  presence  of  cholesteatomata  and 
other  tumors,  and  of  parasites  (cysticercus  cellulosa  in  pig; 
coenurus  cerebralis  in  sheep)  in  the  encephalon,  and  of  injuries 
from  concussion,  degeneration  and  softening  of  the  brain  sub- 
stance. 


Vertigo,     Megrims.     Blind  Staggers.  75 

9th.  Nasal  Vertigo  has  been  noted  by  Cadeac  in  connection 
with  irritation  in  the  nose  and  especially  by  the  larva  of  oestrus 
ovis  (sheep),  and  the  linguatula  (dog,  horse).  In  certain  of  the 
cases  manifested  by  jerking  of  the  head  and  diverging  to  one 
side,  the  recovery  after  section  of  the  pes  anserina  indicates  a 
nasal  origin. 

loth.  Vertigo  from  Narcotics  (alcohol,  lolium  temulentum, 
belladonna,  solanum,  various  essential  oils,  carbon  monoxide, 
etc).,  have  been  already  referred  to. 

nth.  There  remains  to  be  noted  cases  in  which  no  narcotic 
poison,  no  mechanical  disturbance  of  the  circulation,  no  visual, 
aural  nor  nasal  trouble,  no  gastric  nor  hepatic  disorder,  and  not 
even  a  distant  nervous  lesion  can  be  found ;  the  disease  may  in 
such  cases  be  ranked  for  the  present  as  essential  vertigo. 

Symptoms.  As  usually  seen  in  the  horse,  vertigo  often  attacks 
the  nervous,  irritable  animal  in  which  the  slightest  occasion  of 
irritation  or  disturbance  causes  intense  suffering  and  quick  re- 
sponse. This  is  often  aggravated  by  the  plethoric  condition  of 
the  animal,  kept  on  a  liberal  ration  of  grain  and  having  little 
exercise.  In  some  forms  of  the  afiFection,  however,  and  especial- 
ly the  gastric  and  hepatic,  the  subject  is  dull,  carries  the  head 
low,  and  lacks  vivacity  and  energy. 

In  the  first  form  (the  most  common  in  the  horse)  the  animal 
which  has  been  full  of  life  and  vigor,  slackens  his  pace  and  the 
tension  on  the  reins,  or  stops  suddenly,  shakes  the  head,  vertical- 
ly or  horizontally,  or  jerks  it  to  one  side,  trembles,  staggers, 
props  his  legs  outward  for  more  stable  support,  presses  against 
the  pole,  or  the  other  horse,  or  a  wall,  leans  on  the  breeching  or 
hangs  on  the  breast  strap,  plunges  forward,  or  to  one  side,  or 
rears  up  and  even  falls  backward,  and  comes  to  the  ground. 
Profuse  perspiration  ensues,  the  eyes  roll,  the  face  is  pinched  and 
drawn,  the  prostrate  animal  may  struggle  in  a  helpless  way,  and, 
if  the  harness  is  loosened,  he  may  get  up  ip  a  few  seconds  and 
slowly  recover.  Often,  however,  he  remains  for  an  hour  or 
more,  nervous,  sensitive,  bedewed  with  sweat,  trembling  and 
with  anxious  expression.  Such  are  the  more  common  manifes- 
tations of  what  is  familiarly  known  as  blind  staggers.  The 
symptoms  will  vary  however,  with  the  cause. 

In  gastric  or  hepatic  cases  there  may  be  more  particularly 


76  Veterinary  Medicine, 

dullness  and  lack  of  energy,  low  carriage  of  the  head,  unsteadi- 
ness of  gait,  lack  of  lustre  in  the  eye,  pupils  dilated,  semi-closed 
eyelids,  pendent  lips,  a  tendency  to  lean  on  the  stall  or  hang  on 
the  harness,  and  though  the  animal  may  stagger  and  fall,  there  is 
not  the  abrupt  transition  from  life  and  energy  to  the  active  excite- 
ment and  uncontrollable  movements.  The  same  remarks  apply  in 
a  measui;e  to  narcotic  vertigo. 

With  optic  vertigo,  the  attendant  conditions  will  help  to  a 
diagnosis.  The  animal  has  come  from  darkness  to  full  sunshine  ; 
there  is  the  white,  icy  or  snowy  reflection  everywhere  which  the 
animal  was  facing  when  attacked,  or  the  glistening  lake  or  river, 
the  overdraw  check  rein,  or  the  blind  with  perhaps  a  shining  inner 
surface.  The  pupil  is  closed,  and  the  eye  is  rolled  back  or  oscil- 
lates in  one  direction  or  another.  The  symptoms  are  checked  by 
covering  the  eyes  or  removing  the  subject  into  a  dark  building  or 
even  into  the  shade  of  a  tree  or  shed. 

With  aural  vertigo  there  may  be  similar  rolling  of  the  eyes, 
without  the  pupillary  closure,  the  ear  may  be  drawn  down  or 
back,  and  the  shaking  or  jerking  of  the  head  is  likely  to  be  a 
marked  feature.  If  there  is  more  motion  of  one  ear  than  the 
other,  if  the  head  is  jerked  to  the  one  side,  if  there  is  a  measure 
of  deafness  in  the  one  ear  (to  be  ascertained  rather  in  the  inter- 
vals between  attacks),  if  there  is  disease  of  the  pharynx,  the  Eu- 
stachian tube  or  pouch,  or  swelling  about  the  root  of  the  ear,  if 
there  is  wax,  scurf,  or  acarus  in  the  ear,  if  the  animal  rubs  it  fre- 
quently, aural  vertigo  may  be  suspected. 

Nasal  vertigo.  Those  forms  in  which  the  head  is  jerked  hor- 
izontally, vertically,  or  diagonally,  the  animal  pressing  against  its 
mate  or  the  pole,  or  outward  in  the  harness,  and  getting  out  of  its 
track,  even  if  it  should  step  short  of  falling,  and  which  appear 
only  during  work,  or  are  aggravated  by  exertion,  have  been 
attributed  to  lesions  of  the  ear  (Fleming),  but  in  some  cases  they 
can  be  warded  ofiF  by  wearing  a  net  over  the  nostril,  and  can  be 
entirely  stopped  by  complete  transverse  section  of  the  pes  anse- 
rina,  so  that  in  a  certain  number  at  least  they  must  be  accounted 
nasal.  These  are  not  usually  attended  by  sneezing.  The  simple 
expedient  of  driving  with  a  rather  close  net  over  the  nostril  may 
enable  one  to  diagnose  many  of  the  purely  nasal  forms. 

Plethoric  vertigo  may  be  suspected  when  the  attack  comes  on 


Vertigo,     Megrims.     Blind  Staggers,  77 

in  spring,  in  a  fleshy  or  fat  horse,  over-fed  and  little  exercised, 
when  there  is  dark  red  congestion  of  the  nasal  mucosa  and  con- 
junctiva,  and  a  subsidence  with  rest. 

In  the  vertigo  of  brain  lesions,  the  acute  forms  are  attended  by 
fever  and  marked  signs  of  delirium  or  disordered  nervous  func- 
tions, while  in  the  chronic  forms  there  may  be  permanent  hyper- 
aesthesia,  or  anaesthesia,  general  or  with  rather  diffuse  limits,  and 
the  vertiginous  attacks  repeat  themselves  frequently  irrespective 
of  weather,  though  they  may  be  precipitated  by  faults  of  feeding, 
indigestion,  severe  exertion,  or  some  of  the  other  exciting  causes 
above  mentioned. 

These  cases  are  to  be  distinguished  from  epilepsy  by  the  ab- 
sence of  any  spasmodic  contraction,  aside  from  the  jerking  of  the 
head  and  rolling  of  the  eyes,  and  by  the  fact  that  consciousness  is 
retained  throughout.  During  the  attack  the  animal  may  fail  to 
respond  to  irritation  of  the  nasal  mucosa,  but  this  appears  to  be 
due  to  the  fact  that  his  whole  attention  is  engaged  with  k  more 
serious  trouble. 

The  duration  of  an  attack  is  from  one  to  two,  or  exceptionally 
five  minutes.  The  form  which  is  represented  by  jerking  of  the 
head  and  deviation  from  the  direct  line  of  motion  may  continue 
so  long  as  exercise  is  kept  up. 

In  the  nasal  vertigo  of  sheep  and  dogs,  due  to  parasites, 
sneezing,  and  congestion  of  the  mucosa  are  to  be  looked  for. 

In  the  cerebral  parasitic  vertigo  of  sheep  and  pigs,  the 
symptoms  vary  according  to  the  seat  of  the  parasite.  These  may 
be  blindness,  turning  in  a  circle,  moving  straight  ahead  regard- 
less of  obstacles,  jerking  upward  of  the  head  with  nose  protruded, 
hemiplegia,  hemiansesthesia,  cross  hemiplegia,  cross  hemianaes- 
thesia,  and  any  one  of  the  many  forms  of  paralysis,  or  exagge- 
rated nervous  action.  The  animal  usually  turns  to  the  side  on 
which  the  parasite  lies  and  is  paralyzed  on  the  opposite  side  of 
the  trunk.  A  peculiarity  of  these  cases  is  that  while  the  symp- 
toms are  continuous,  yet  there  are  periodic  aggravations  which 
bear  no  relation  to  feeding,  exertion  or  excitement,  but  depend 
on  the  protrusion  at  intervals  of  the  heads  of  the  parasites  into 
the  brain  substance.  If  there  are  several  parasites  in  the  brain 
and  they  do  this  at  different  times  the  symptoms  are  liable  to 
vary  according  to  their  seat,  and  the  special  organ  which  is  irri- 


78  Veterinary  Medicine, 

tated.  This  variability  of  syjnptoms  is  suggestive  of  parasitism. 
While  turning  around  in  a  circle  has  been  already  noticed 
there  remains,  in  certain  cerebral  forms,  the  peculiar  phenome- 
non of  the  animal  rotating  rapidly  on  its  longitudinal  axis.  The 
patient  falls  on  its  side  and  rolls  over  and  over.  Among  the 
brain  lesions  with  which  it  has  been  experimentally  identified  are 
injuries  to  the  middle  peduncles  0/  the  cerebellum  ^  or  of  the  supero- 
external  portion  0/  the  cerebral  peduncles,  or  of  the  posterior  part 
of  the  encephalon,  or  of  different  parts  of  the  hemispheres. 

Cases  of  vertigo  that  occur  without  an}*  appreciable  lesions  have 
been  named  essential  vertigo,  Guibert  has  attributed  some  cases 
to  irritation  of  the  lower  part  of  the  limbs  by  contact  with  the 
litter  but  this  could  only  occur  in  an  animal  in  which  the  nervous 
system  was  in  a  morbidly  excitable  condition. 

Treatment,  The  prophylactics  and  therapeutics  of  vertigo 
will  vary  with  the  cause.  The  diagnosis  of  the  cause  is  there- 
fore the  most  important  step.  In  pampered,  overfed,  idle  horses 
a  reduced  ration  and  daily  exercise  or  work  will  often  suffice. 
It  is  usually  desirable,  however,  to  remove  intestinal  irritants 
and  deplete  the  vascular  system  by  an  active  purgative.  If  the 
attacks  appear  only  in  Spring  this  care  should  be  especially  given 
at  such  seasons.  A  tight  or  badly  fitting  collar  should  be  cor- 
rected, also  a  position  of  the  breast  strap  which  causes  it  to  press 
on  the  jugular  veins.  A  short  bearing  rein  causing  undue 
flexion  of  the  head  must  be  lengthened  or  abandoned.  A  too 
dark  stable  should  be  avoided,  also  the  sudden  exposure  to  white, 
dusty  roads  and,  still  more  so,  to  the  glare  of  snow,  ice,  or 
water.  A  short,  overdraw  check  rein,  turning  the  eyes  up 
directly  into  the  sun*s  rays,  or  blinds  with  a  glistening  inner  sur- 
face may  require  correction.  It  may  be  better  to  abandon  blinds 
altogether,  or  to  cover  the  eyes  by  a  piece  of  leather,  2  to  4 
inches  wide,  extending  across  the  forehead  from  one  eyef  to  the 
other  ;  or  a  sunshade  attached  to  the  headstall  may  be  worn  so 
as  to  protect  the  eyes.  Horses  which  become  seasick  or  carsick 
may  sometimes  be  helped  by  covering  the  eyes.  Other  indica- 
tions would  be  to  treat  any  existing  trouble  which  interferes  with 
a  normal  circulation  in  the  brain  (pulmonary  congestion,  aneu- 
risms, tumors  pressing  on  carotids  or  jugulars,  phlebitis,  etc.), 
and  such  as  affect  the  ear  (disease  of  the  pharynx,  guttural 


Vertigo.     Megrims.     Blind  Staggers.  79 

pouches,  adjacent  glands,  petrous  temporal  bone,  membrana 
tympani,  external  ear).  Indurated  wax,  insects  or  insect  larvae 
may  be  removed  by  careful  irrigation  with  warm  water,  and  per- 
haps by  chloroform.  Nasal  parasites  must  be  washed  out  or  de- 
stroyed by  benzine,  and  any  hyperaesthesia  of  the  nasal  mucosa 
maybe  met  by  covering  the  nostril  with  a  net,  or  radically  by 
cutting  the  facial  branch  of  the  5th  nerve  as  it  emerges  from  the 
infra-orbital  foramen. 

When  attacked  the  horse  should  be  at  once  stopped  and  put 
under  the  shadow  of  a  roof  or  tree,  or  in  their  absence,  a  blanket 
or  lap  robe  may  be  used  to  cover  his  eyes.  If  there  is  danger  of 
falling  remove  the  harness,  and  secure  a  soft  piece  of  ground, 
free  from  stones  or  other  hard  bodies.  Cold  water  applied  to  the 
head  will  sometimes  check.  A  common  practice  is  to  bleed  from 
the  palate,  and  in  plethoric  cases  especially,  and  in  such  as  are 
dependent  on  congestion,  tumors  or  other  lesion  of  the  brain  it  is 
to  be  commended.  The  action  will  be  rendered  more  prompt  and 
efFective  if  the  blood  is  taken  from  the  jugular.  A  laxative  diet, 
and  carefully  reg^ulated  work  are  desirable  to  obviate  the  tendency 
to  the  a£Fection,  and  this  may  often  be  accomplished  by  a  run  at 
pasture.  Otherwise  daily  small  doses  of  Glauber  salts  in  the  feed 
may  suffice.     Bromides  may  be  used  to  calm  nervous  excitement. 

In  cases  of  gastric  vertigo  an  active  cathartic,  followed  by 
smaller  laxative  doses  or  a  laxative  diet  and  a  course  of  bitters 
may  prove  useful.  Such  cases  should  never  be  worked  on  a  full 
stomach  but  should  be  left  at  rest  at  least  for  an  hour  after  a  meal. 

In  aural  vertigo  special  attention  must  be  given  to  the  throat, 
and  external  ear.  Bromides  may  often  be  useful,  and  sometimes 
benefit  may  be  derived  from  an  occasional  blister  or  light  firing 
back  of  the  ear. 

In  coenurus  cerebralis  in  sheep  the  only  resort  is  to  trephine 
and  remove  the  parasite. 


CONCUSSION  OF  THE  BRAIN. 

Definition.  Causes :  leaps,  trips,  falls,  blows.  Symptoms  :  fall,  insensi- 
bilitj,  flaccidity,  suspended  respiration,  tumors,  vomiting,  recovery,  signs 
of  cerebral  congestion.  Pathology  :  anaemia  followed  by  congestion.  Diag- 
nosis :  from  fracture,  epilepsy.  Treatment :  quiet,  rubbing  of  limbs,  am- 
monia, cold  to  head,  or  heat ;  for  congestion,  bromides,  depletion, -ice  pack, 
derivatives. 

Definition,  Concussion  is  the  condition  produced  by  mechani- 
cal jar  or  shock  of  the  cerebral  mass,  and  manifested  by  modifi- 
cation of  the  brain  functions  of  any  grade  from  a  simple  dazed 
condition  to  that  of  complete  unconsciousness. 

Causes.  The  most  familiar  cause  is  the  stroke  of  the  butcher's 
pole  ax,  producing  sudden  and  absolute  insensibility.  A  horse 
in  leaping,  trips  and  falls  on  his  head  or  running  against  a  wall 
sustains  a  concussion,  which  leaves  him  for  some  seconds  without 
any  signs  of  life.  The  same  will  happen  to  other  animals,  but 
above  all  to  rams  which  in  their  combats,  back  for  a  number  of 
yards  and  running  together  meet  with  a  shock  from'  the  efiFect  of 
which  even  their  thick  skulls  cannot  save  them.  Other  blows 
upon  the  head  operate  to  the  same  end. 

Symptoms,  Concussion  is  manifested  by  different  grades  of 
symptoms.  At  first  there  is  usually  a  fall  with  complete  insen- 
sibility. The  animal  lies  flaccid,  utterly  insensible  to  external 
irritation  and  there  is  suspension  of  respiration.  The  heart  con- 
tinues to  beat  and  a  frequent  weak  pulse  may  be  often  detected. 
In  slight  cases,  breathing  may  be  re-established  at  the  end  of  a 
minute  or  two,  with  muscular  tremors  and  movements  of  the 
limbs  ;  then  the  animal  rises,  shakes  his  head,  neighs,  and  walks 
at  first  unsteadily  and  afterward  with  greater  and  greater  firmness. 
In  vomiting  animals,  emesis  occurs. 

In  some  cases  this  may  be  followed,  after  an  hour  or  two,  by 
signs  of  congestion,  heat  of  the  head,  redness  of  the  eyes,  irri- 
tability, or  dullness  and  stupor  and  perhaps  muscular  twitching. 
This  may  improve  or  it  may  terminate  in  death  preceded  by 
spasms,  general  convulsions,  rolling  of  the  eye  balls,  and  stupor 
or  coma  with  general  muscular  relaxation. 

The  primary  condition  is  usually  an  anaemia  of  the  cerebral 
80 


Concussion  of  the  Brain,  8i 

matter  as  seen  in  the  brain  of  the  animal  suddenly  killed  by  the 
blow  of  a  hammer.  The  return  of  consciousness  or  semi-con- 
sciousness is  connected  with  the  resumed  freedom  of  the  cerebral 
circulation.  The  later  convulsions,  stupor  or  coma,  usually  imply 
active  congestion  or  the  effusion  of  blood  on  the  brain  surface,  or 
in  its  substance. 

Diagnosis  from  fracture  must  be  made  mainly  by  manipula- 
tion of  the  bone  in  the  seat  of  the  blow,  and  by  the  absence  of 
the  increasing  stupor  and  coma  which  attend  on  pressure  from 
a  gradually  increasing  blood  clot.  Prom  epilepsy  it  is  to  be  dis- 
tinguished by  the  evidence  of  mechanical  injury,  by  the  absence 
of  spasms  at  the  first,  by  the  suspension  of  breathing  and  the 
absence  of  froth  about  the  lips. 

Treatment.  Keep  the  patient  still  and  prostrate  until  there  are 
signs  of  returning  respiration  and  free  cerebral  circulation.  This 
may  be  hastened,  however,  by  active  rubbing  of  the  limbs  and 
l>ody,  by  giving  guarded  inhalations  of  ammonia,  or  even  by 
friction  of  the  skin  with  ammonia  and  oil.  Sometimes  reaction 
is  favored  by  dashing  cold  water  on  the  head,  while  in  other 
cases  hot  water  to  the  poll  will  prove  more  effective,  or  the 
two  may  be  used  alternately  with  good  results. 

If,  after  partial  recovery,  there  is  marked  restlessness,  or  ir- 
ritability it  may  be  met  with  bromides.  If  secondary  uncon- 
sciousness supervenes  effusion  of  serum  or  blood  is  to  be  feared, 
or  extreme  congestion,  and  blood  may  be  drawn  from  the  jug- 
ular or  by  cups  from  the  cranium,  and  ice  bags  or  cold  water 
may  be  applied  to  the  head.  Hot  foot  baths  or  mustard  embro- 
cations applied  to  the  limbs,  and  even  derivation  toward  the 
bowels  may  be  used.  The  indications  for  treatment  come  to  be 
for  meningo-encephalitis. 


LIGHTNING  STROKE.     ELECTRIC  SHOCK. 

Fatal.  Non-fatal.  Herbivora  at  pasture  under  tree.  Symptoms  :  dazed 
for  a  few  minutes,  unconscious  for  hours,  permanent  paresis  or  paralysis- 
Lesions  :  lines  of  burned  hair,  skin  or  muscles,  rigor  mortis  slight,  decompo- 
sition rapid,  bluish  black  venous  and  capillary  congestion,  extravasations, 
blood  fluid.  Diagnosis.  Treatment :  ammonia,  ether,  alcohol,  caffein, 
nerve  stimulants. 

While  a  stroke  of  lightning  is  usually  fatal,  yet  in  certain  cases, 
the  victim  is  but  temporarily  stunned  and  recovers  with  more  or 
less  remaining  paralysis.  The  subject  has  also  great  importance 
in  connection  with  the  claim  of  the  owner  against  a  company  which 
may  have  insured  his  stock  against  lightning. 

Any  animal  may  be  struck,  but  the  herbivora  which  are  turned 
out  to  pasture  are  especially  liable  to  such  injuries,  because  they 
seek  shelter  under  trees,  which  operate  as  lightning  rods. 

Symptoms,  In  slight  cases  of  shock  whether  by  lightning  or 
the  current  of  a  hanging  live  electric  wire,  the  subject  may  be 
simply  dazed  and  may  or  may  not  fall  to  the  ground,  and  recover 
itself  in  a  very  few  minutes.  In  other  cases  there  is  a  more 
violent  shock  which  prostrates  the  animal  to  the  earth,  where  it 
may  lie  unconscious  for  some  hours  and  yet  quickly  and  com- 
pletely recover.  In  still  other  cases  after  such  prostration  re- 
covery is  incomplete  and  the  animal  remains  affected  with  pare- 
sis or  paralysis  of  one  or  more,  commonly  of  both  hind,  or  all  four 
limbs.     In  the  more  violent  shocks  death  is  instantaneous. 

Often  the  impact  and  course  of  the  current  are  marked  by 
visible  lesions.  Sometimes  the  skin  is  wounded  exposing  a  bluish 
black  tissue  beneath.  More  commonly  there  is  an  area  of  burnt 
hair,  or  straight,  radiating  or  angular  lines  of  raised  and  frizzled 
hair  marking  the  course  of  the  current.  In  a  horse  killed  by  an 
electric  light  wire  in  Ithaca  recently  the  current  had  burned  to  a 
depth  of  several  inches  in  the  muscles  of  the  shoulder  which 
rested  on  the  wire. 

Lesions  are  often  rather  indefinite.  There  may  be  no  appre- 
ciable change  in  the  nervous  system.  Rigor  mortis  is  slight ;  it 
passes  off  rapidly  and  decomposition  sets  in  early.  The  venous 
system  and  capillaries  are  usually  filled  with  liquid  blood  of  a 
82 


Lightning  Stroke.     Electric  Shock,  83 

dark  bluish  black  color,  and  at  intervals  are  points,  spots  and 
patches  of  blood  extravasation.  The  uniformly  liquid  state  of 
the  blood  is  one  of  the  most  marked  phenomena  of  death  from 
electricity.  The  dark  blue  congestion  of  the  radical  veins  is  also 
very  pathognomonic,  the  part  struck  or  traversed  by  the  main 
current,  being  the  seat  of  the  most  elaborate  arborescent  network. 
This  arborescent  appearance  of  the  dark  colored  veins,  and  the 
petechiae  are  often  marked  in  the  internal  organs  (brain,  kidneys 
liver,  lungs). 

Diagnosis,  The  environment  of  the  animal  will  often  clear  the 
diagnosis.  The  patient  is  found  helpless,  or  dead  under  a  tree 
by  a  pole,  or  under  a  hanging  wire,  and  if  a  tree  there  are  evi- 
dences of  the  electric  shock  in  scattered  leaves  and  branches, 
stripping  off  of  the  bark,  or  perhaps  rending  of  the  tree  in  pieces. 
In  case  of  wires  attached  to  or  passing  near  such  a  tree,  the  sup- 
porting poles  show  similar  splitting  and  rending.  Add  to  these 
the  fluidity  of  blood  in  the  carcase,  the  thickly  ramifjring  network 
of  the  minute  dark  bluish,  red  veins,  the  petechise  and  the  com- 
parative absence  of  cadaveric  rigidity,  and  we  have  a  picture  very 
significant  of  lightning  stroke. 

Treatment  in  such  cases  is  according  to  the  condition.  The 
primary  unconsciousness  is  met  by  inhalations  of  ammonia  or 
ether,  or  the  injection  of  brandy  or  alcohol  subcutem.  Caffein, 
atropine  or  hyoscyamin  may  be  used  as  substitutes.  If  conscious- 
ness returns  recovery  is  usually  rapid  and  complete.  Should 
paresis  or  paralysis  remain  it  must  be  treated  like  any  ordinary 
case  of  these  affections. 


INTRACRANIAL  HAEMORRHAGE  AND  THROMBOSIS. 
APOPLEXY.     SOFTENING  OF  THE  BRAIN. 

Definition.  Cauaes  :  Nature  :  intracranial  rupture,  with  pressure,  serous 
effusion,  excessive  congestion,  experimental  cases,  ansemia  from  pressure, 
comparative  immunity  of  horse,  heart  disease,  Bright's  disease,  atheroma, 
degeneration,  emboli,  age,  blood  tension,  severe  exertion,  excitement,  con- 
cussion, insolation,  venous  obstruction,  toxins,  neoplasms.  Lesions :  blood 
clots,  small  and  multiple,  large  and  solitary,  brain  absorption,  cavities,  cysts. 
Symptoms :  dullness,  swaying,  trembling,  elevation  of  head,  turning  in  circle, 
sudden  fall,  spasms,  unequal  dilated  or  contracted  pupils,  eyes  turned  to 
affected  side,  congested  or  anaemic  mucosae,  stertor,  puffing  cheeks  except 
in  solipeds,  pulse  slow,  soft,  full,  vomiting,  stupor,  coma,  unconsciousness, 
paralysis,  monoplegia,  hemiplegia,  sequelse.  Diagnosis:  sudden  uncon- 
sciousness, with  little  spasm,  but  paralysis,  history,  sign  of  trauma,  deep 
coma,  eyes  turned  to  one  side,  pupils  unequal,  stertor,  slow  breathing  and 
pulse  ;  from  uraemia,  pulmonary  apoplexy,  oedema  or  anthrax.  Treatment : 
bleeding,  ice  pack,  snow,  cold  water,  rest,  derivatives  to  limbs,  later  purge, 
bromides,  potassium  iodide,  tonics,  open  air  life. 

Definition,  Cerebral  apoplexy  has  been  defined  as  a  sudden 
loss  of  sensation  and  voluntary  motion,  from  pressure  originating 
within  the  cranium  and  followed  by  paralysis,  often  unilateral. 
The  definition  is  somewhat  insufficient  as  regards  the  early  symp- 
toms as  the  same  conditions  attend  on  convulsions  and  epilepsy 
(haut  mal),  and  it  is  only  by  excluding  these  by  their  character- 
istic features  of  sudden  seizure  with  clonic  spasms  and  th^ir  inter- 
mittent and  paroxysmal  habit  that  we  reach  an  easy  and  satisfac- 
tory distinction.  Later  the  paralysis  tends  to  identify  the  apo- 
pletic  attack. 

Causes  and  Nature,  The  immediate  cause  and  essential  lesion 
of  apoplexy  has  been  generally  held  to  be  the  rupture  of  an  intra- 
cranial artery  and  the  formation  of  a  considerable  blood  clot  which 
presses  upon  (and  abolishes  the  functions  of)  the  brain.  There 
are  cases,  however,  in  which  the  characteristic  symptoms  are 
present,  and  yet  a  complete  recovery  ensues  at  an  early  date,  too 
early  to  allow  for  the  absorption  of  a  considerable  clot.  Moreover, 
in  fatal  cases  perhaps  no  blood  clot  is  to  be  found,  but  in  place  a 
serous  effusion,  or  an  internal  congestion  which  exercised  the 
fatal  pressure  on  the  brain.  So  far,  therefore,  as  clinical  phe- 
84 


Apoplexy  and  Softening  of  the  Brain,  85 

nomena  are  concerned,  we  must  allow  that  apoplexy  may  arise 
from  any  sudden  pressure  on  the  brain  substance.  Pagenstecher 
produced  the  s5anptoms  of  the  disease  by  injecting,  at  a  regulated 
pressure,  melted  wax  and  tallow  between  the  skull  and  dura 
mater  in  the  dog.  In  the  moderate  cases  there  were  drowsiness, 
psychic  depression  and  general  muscular  weakness.  In  the  more 
severe  ones  there  were  added  sleep  and  unilateral  paralysis.  In 
the  more  extreme  cases  death  followed  in  a  few  hours  after  coma 
set  in,  though  in  some  of  these  a  partial  recovery  ensued  if  the 
waxy  mass  was  scooped  out  before  the  fatal  symptoms  appeared. 
Cases  ended  fatally  only  when  the  injection  pressure  equalled 
that  of  the  blood,  and  convulsions  occurred  only  when  the  pres- 
sure was  unsteady.  The  temperature  fell  as  it  does  in  apoplexy 
in  man,  at  the  outset,  but  it  continued  falling  to  the  fatal  issue 
contrary  to  what  takes  place  in  man. 

Duret  injected  water  into  the  cranium  of  animals  so  as  to  pro- 
duce great  tension  of  the  occipito-atloid  membrane  causing  there- 
by arrest  of  the  respiration  and  slowing  of  the  heart's  action.  On 
tearing  the  membrane  so  as  to  allow  escape  of  the  water,  respira- 
tion began  anew  and  consciousness  was  gradually  restored. 

Edes  sustains  the  view  that  apoplexy  is  directly  due  to  anaemia 
of  a  lesser  or  greater  portion  of  the  brain  substance,  and  that  this 
need  not  be  in  any  one  particular  seat  nor  of  any  definite  extent. 
This  anaemia  is  usually  induced  by  pressure  and  may  be  caused 
by  effused  blood,  or  serum,  or  by  the  extreme  congestion  due  to 
narcotic  poisons,  or  other  cause.  Embolism  of  a  cerebral  vessel, 
however,  by  cutting  oflF  the  blood  from  the  part  of  the  brain 
which  it  supplies  inay  give  rise  to  the  apoplectic  phenomena. 

Friedberger  and  Frohner  found  apoplexy  quite  frequent  in 
sheep,  ox,  and  dog,  and  rare  in  the  horse,  although  more  subject 
to  the  violent  exertion  which  they  put  in  the  front  of  all  causes. 
It  is  probable  that  the  sluggish,  pampered  life  of  the  first  three 
animals,  and  the  tendency  to  fatty  degenerations  and  heart  disease 
introduces  a  special  predisposition  as  it  does  in  man,  while  the 
horse,  inured  to  an  open  air  life  and  a  vigorous  muscular  condi- 
tion, is  comparatively  immune.  Bright's  disease  is  a  common 
cause  in  the  human  subject,  with  its  resulting  cardiac  hypertrophy. 
The  degenerations  attendant  on  these  conditions  and  especially 
fatty  change  (atheroma)  in  the  walls  of  the  cerebral  arteries. 


86  Veterinary   Medicine, 

pave  the  way  for  their  rupture  and  for  blood  effusion.  Emboli 
also  carried  from  the  diseased  heart  not  only  cut  off  the  blood 
from  the  parts  supplied  by  the  plugged  arteries,  but  increase  the 
blood  tension  on  the  cardiac  side  of  the  obstruction  and  endanger 
rupture  at  any  weak  part.  Thus  they  may  cause  apoplexy  from 
anaemia  without  rupture  or  apoplexy  from  the  pressure  of  effused 
blood. 

Age  which  is  such  a  notorious  factor  in  man  is  nol  without  its 
inflence  in  the  lower  animals.  It  is  in  the  old  that  we  mostly 
see  disease  of  kidneys  and  heart  and  the  degenerations  of  the  tis- 
sues, including  the  brain  and  its  vessels  ;  in  these,  therefore,  rupt- 
ture  and  extravasation  are  the  most  frequent. 

The  other  causes  are  mostly  connected  with  increased  blood 
tension  with  or  without  a  debility  of  the  vascular  walls.  Violent 
exertions  as  in  racing,  coursing,  dragging  heavy  loads  up  hill  or 
on  heavy  ground,  severe  excitement,  cerebral  concussion,  insola- 
tion, and  intense  congestion  of  the  brain  substance  have  all  been 
recognized  as  causative  factors.  The  compression  of  the  jugulars 
by  a  small  collar,  the  violent  straining  attendant  on  parturition, 
or  constipation,  and  even  the  retrocession  of  blood  from  the  sur- 
face when  exposed  to  extreme  cold,  may  contribute  to  the  final 
rupture. 

In  infectious  diseases  in  which  the  toxic  products  tend  to  pro- 
duce profound  modifications  in  the  blood  and  tissues,  extravasa- 
tions are  met  with  in  the  brain  as  in  other  organs.  Thus  they  are 
seen  in  anthrax,  Texas  fever,  petechial  fever,  etc. 

Then  the  formation  of  neoplasms  in  the  brain  may  be  the  oc- 
casion of  the  rupture  of  the  vascular  walls  and  apoplexy. 
Hsematoma  of  the  dura  in  the  dog  (Friedberger  and  Frohner), 
cholesteatohiata  in  the  horse,  and  carcinoma  may  be  apparent 
causes. 

The  effect  of  mechanical  injury  must  be  admitted,  as  blows 
on  the  head,  injuries  from  an  ox  yoke,  and  concussions  during 
the  battles  of  rams  and  bulls. 

Lesions.  Blood  extravasations  may  be  found  at  any  part  of  the 
brain  :  a.  into  the  brain  substance ;  b.  into  the  ventricles  ; 
c.  from  the  pia  mater ;  d.  into  the  arachnoid  sac ;  e.  between 
the  skull  and  dura  mater.  It  is  especially  common  in  connection 
with  the  ganglia  adjoining  the  ventricles  ;  the  corpus  striatum,. 


Apoplexy  and  Softening  of  the  Brain.  87 

optic  thalamus,  the  corpora  quadrigemini,  the  fornix.  In  other 
cases  the  cms  cerebri,  pons,  medulla  oblongata,  corpus  calosum. 
In  other  cases  the  convolutions  of  the  cerebrum  or  cerebellum 
suffer.  The  amount  of  effusion  may  be  limited  to  a  few  drops  or 
it  may  cover  an  extensive  area  and  cause  considerable  flattening 
of  the  brain  substance. 

When  capillary  haemorrhages  are  present — the  size  of  a  millet 
seed  or  a  pea — Friedberger  and  Frohner  have  usually  found 
them  multiple,  but  when  large  enough  to  form  distinct  clots 
they  are  usually  single  and  confined  to  one  side.  If  a  clot,  in- 
volving the  brain  substance,  is  small,  it  merely  separates  the 
nervous  fibres,  but  if  larger,  the  cerebral  tissue  is  broken  down 
in  the  mass  of  clot,  discolored,  torn  and  softened.  If  the  patient 
has  survived  the  first  attack  the  clot  passes  through  the  different 
stages  of  discoloration,  brown,  brownish  yellow,  yellow,  and  may 
become  fibrous  forming  a  distinct  cicatrix,  with  loss  of  brain  sub- 
stance. In  connection  with  the  partial  absorption  of  the  effused 
blood,  cavities  may  be  filled  with  a  serous  fluid  (apoplectic  cysts), 
and  these  may  show  multiple  loculi.  The  nerve  fibres  which 
lead  to  an  old  standing  lesion  are  usually  degenerated. 

When  effused  into  a  ventricle,  blood  is  less  readily  absorbed 
and  tends  to  remain  as  a  flattened  discolored  layer. 

Extravasation  between  the  dura  mater  and  the  cranium  is 
probably  always  the  result  of  direct  mechanical  violence. 

Symptoms,  Premonitory  indications  of  apoplexy  are  less  com- 
monly recognized  in  the  lower  animals  than  in  man,  doubtless 
largely  because  of  the  impossibility  of  appreciating  subjective 
symptoms.  The  first  observed  indications  are  usually  dullness, 
some  lack  of  coordination  of  movement,  swaying,  unsteady  gait, 
trembling  and  a  tendency  to  deviate  to  one  side  or  to  move  in  a 
circle.  In  the  majority  of  cases,  however,  the  first  symptoms 
noticed  are  a  complete  loss  of  consciousness  or  nearly  so,  a 
sudden  fall  and  often  more  or  less  convulsive  movements  of  the 
limbs  aggravated  by  any  excitement. .  The  eyes  remain  dilated, 
the  pupils  enlarged  or  sometimes  contracted,  and  in  case  of  uni- 
lateral effusion  the  axis  of  vision  of  both  eyes  is  turned  to  the 
affected  side,  right  or  left.  The  pupil  of  one  eye  is  likely  to  be 
more  widely  dilated  than  that  of  the  other.     Rolling  of  the  eye- 


88  Veterinary  Medicine. 

balls  is  not  uncommon.  Convulsions  may  occur,  the  head  and 
hind  limbs  being  drawn  back  forcibly  as  in  oposthotonos,  or  the 
animal  may  lie  flaccid  and  comatose  from  the  first.  The  nasal, 
buccal  and  orbital  mucous  membranes  are  usually  congested, 
deep  red  or  livid,  yet  sometimes  they  are  anaemic  and  pale 
(Shock).  The  breathing  is  usually  characteristic,  being  deep, 
slow,  labored,  irregular  and  stertorous  and  accompanied  by 
puffing  out  of  the  cheeks  at  each  expiration  (except  in  solipeds). 
Yet  there  are  cases  in  which  stertor  is  absent.  The  pulse  is 
usually  slow,  full  and  soft,  and,  in  the  carotids,  throbbing,  but 
it  may  be  weak  and  imperceptible.  There  may  be  complete  un- 
consciousness, and  again  from  the  first,  or  nearly  so,  there  may 
be  a  slight  response  to  a  stimulus,  which  cannot  be  referred  alto- 
gether to  reflex  action.  In  vomiting  animals,  emesis  may  ensue. 
Stupor  and  coma  are  more  or  less  marked,  though  liable  to  inter- 
missions under  any  cause  of  irritation. 

Along  with  the  above  symptoms  the  spasms  and  sequent 
paralysis,  are  significant.  If  confined  to  given  muscles  or  groups 
of  muscles  (monoplegia)  it  usually  implies  pressure  on  some 
special  cortical  convolutions  presiding  over  thiese  muscles,  and 
convulsions  are  to  be  expected.  If  there  is  hemiplegia  it  is  sug- 
gestive of  implication  of  the  medulla  or  pons  on  the  opposite 
side,  or  of  a  clot  on  the  corpus  striatum  or  extensively  on  one 
side  of  the  cerebrum.  A  clot  in  the  lateral  ventricle  tends  to 
profound  coma.  So  liable,  however,  is  pressure  to  be  extended 
from  one  side  of  the  brain  to  the  other,  and  irritation  on  the  one 
side  to  rouse  a  corresponding  condition  on  the  opposite  side,  or 
in  related  ganglia,  that  deductions  of  this  kind  cannot  always  be 
implicitly  reli^  on. 

Though  an  animal  should  recover  from  an  attack  there  is  liable 
to  remain  some  modification  of  the  nervous  functions,  partial 
anaesthesia,  circumscribed  paresis,  dullness,  lack  of  energy,  irrit- 
ability, or  muscular  atrophy. 

Cerebral  embolism  and  thrombosis  and  their  sequelae,  infarction 
and  softening,  give  rise  to  corresponding  symptoms,  according  to 
the  seat  of  the  lesion,  and  like  lesions  of  the  blood  vessels  pre- 
dispose to  subsequent  attacks. 

Diagnosis  is  based  largely  on  the  appearance,  usually  sudden 


Apoplexy  and  Softening  of  the  Brain,  89 

but  sometimes  slow,  of  a  more  or  less  profound  unconsciousness, 
attended  or  followed  by  paralytic  troubles.  The  history  of  the 
case  may  assist,  any  blow  on  the  head,  or  sustained  by  falling, 
striking  a  wall  or  post,  or  wearing  a  yoke,  is  to  be  noted.  Any 
extraordinary  exertion  or  excitement  must  be  considered.  Any 
sign  of  injury  about  the  head  ;  the  congestion  of  the  cephalic 
mucous  membranes  in  contrast  with  the  pallor  of  shock ;  the 
onset  of  the  attack  without  convulsions  (or  with  them  as  in  epi- 
lepsy) ;  the  deep  coma  indicating  cerebral  haemorrhage  or  nar- 
cotic poisoning  ;  the  absence  of  the  odor  of  alcohol,  opium,  or 
other  narcotic  from  the  breath  ;  the  turning  of  the  eyes  to  one 
side  and  the  inequality  of  the  pupils  on  the  two  sides  ;  the  turn- 
ing of  the  head  to  the  same  side. as  the  eyes  ;  the  slow,  labored, 
usually  stertorous  breathing  ;  the  slow,  full,  soft  pulse  ;  the  oc- 
casionally rigid  condition  of  the  muscles  and  finally  the  paralysis, 
hemiplegic  and  less  frequently  monoplegic  or  paraplegic,  make 
up  the  diagnostic  picture. 

Ungmia  and  diabetic  coma  may  be  excluded  by  examination  of 
the  urine,  pulmonary  apoplexy  or  adema  by  the  predominance  of 
respiratory  troubles,  and  fulminant  anthrax  by  the  examination 
of  the  blood  and  by  the  fact  that  this  disease  does  not  prevail  in 
the  locality. 

Treatment  is  very  unsatisfactory  in  the  lower  animals,  as  the 
disease  is  very  fatal,  and  unless  recoveries  are  complete,  they  are 
not  pecuniarily  desirable.  It  is  only  in  the  slighter  cases,  there- 
fore, that  treatment  can  be  recommended.  At  the  very  outset  no- 
thing is  better  than  a  full  bleeding  in  a  large  stream  from  the 
jugular  vein  or  temporal  artery.  Ice,  snow,  or  cold  water  should 
meanwhile  be  applied  to  the  cranial  region.  Absolute  rest  should 
be  given,  any  harness  that  would  impede  circulation  or  respiration 
removed,  and  hot  water  or  stimulating  embrocations  applied  to 
the  limbs. 

When  consciousness  returns  and  the  patient  can  swallow,  an 
active  purgative  may  be  administered,  or  barium  chloride  or 
eserine  may  be  given  subcutem.  Any  recurring  heat  of  the  head 
may  be  met  by  renewal  of  cold  applications,  and  the  force  of  the 
circulation  may  be  kept  in  check  by  small  doses  of  bromides  or 
aconite.  In  case  of  the  formation  of  a  clot,  iodide  of  potassium 
and  other  alkaline  agents  may  be  resorted  to.     Quiet  and  the 


90  Veterinary  Medicine, 

avoidance  of  all  excitement  together  with  a  laxative  non-stimu- 
lating diet  must  be  secured  throughout.  A  course  of  vegetable 
or  mineral  tonics  and  an  occasional  blister  to  the  side  of  the  neck 
may  prove  a  useful  sequel. 


CEREBRAI.  HYPER-^MIA. 

MENINGO — ENCEPHAUC   CONGESTION. 

Passive  and  active  hypenetnia.  Causes  :  passive :  obstacles  to  return  of 
blood  :  anaemia :  active :  brain  excitement,  sunstroke,  violent  exertion,  fear, 
abdominal  tympany,  ptomaines,  narcotics,  lead,  darnel,  millet,  leguminous 
seeds  partly  ripened,  tumors,  parasites.  Symptoms :  horse :  variable,  vertigo, 
stupor,  convulsions,  apoplexy,  irritability,  disorderly  movements,  strong, 
hard  pulse,  congested  mucosae,  heat  of  head,  dullness,  drowsiness,  lethaigy, 
coma,  alternating  periods  of  violence,  aggravated  by  what  tends  to  increase 
vascularity  of  brain,  congested  optic  disc  :  cattle  :  parallel,  with  special  heat  of 
horns  :  dogs :  similar,  with  desire  to  move,  or  wander,  or  has  nausea,howls, 
snaps.  Treatment :  cold  to  head,  derivation  to  limbs  and  bowels,  chloral, 
bromides,  ergot,  bleeding,  darkness,  coolness,  non -stimulating  food. 

Congestion  of  the  encephalon  is  treated  here  as  a  pathological 
entity,  though  it  cannot  always  be  distinguished  clinically  from 
some  forms  of  vertigo  on  the  one  hand  and  from  the  milder  types 
of  apoplexy  or  encephalitis  on  the  other.  It  has  been  divided 
into  passive  or  venous  hypercemia  and  active  or  arterial  hyperemia. 

Passive  hyperemia,  as  shown  under  vertigo  and  apoplexy  is  a 
common  result  of  a  tight  collar,  a  tight  strap  used  for  crib-biting,  a 
too  short  bearing  rein,  dilation  or  valvular  disease  of  the  right 
heart,  or  disease  of  the  lungs,  violent  efforts  in  running,  draught, 
etc.  It  tends  to  be  associated  with  arterial  anaemia  on  the  princi- 
ple that  the  closed  cranial  cavity  can  only  admit  a  certain  amount 
of  blood  and  if  an  excess  accumulates  in  the  veins  and  capillaries, 
this  must  be  compensated  first  by  the  movement  backward  to  the 
spinal  canal  of  the  cerebro-spinal  fluid,  and  second  by  the  dimi- 
nution of  the  blood  in  the  cerebral  arteries. 

Active  hyperemia,  may  be  brought  about  by  any  excitement 
which  especially  affects  the  brain.  This  has  been  already  noted 
in  connection  with  insolation  (sunstroke).     It  may  result  from 


Cerebral  Hyperemia  91 

severe  exertion  during  hot  weather,  in  a  violently  contested 
race,  in  drawing  a  heavy  load  up  hill,  or  in  harsh  training. 
Violent  exertion  just  after  a  meal  is  especially  injurious.  Also 
the  excitement  of  travelling  by  rail,  or  that  caused  by  proximity 
to  locomotives,  to  discharges  of  firearms  and  to  other  causes  of 
great  fear ;  encreased  blood  tension  in  the  cerebral  vessels  in 
connection  with  hypertrophy  of  the  left  ventricle,  or  obstruction 
in  other  vessels  (of  the  limbs)  so  as  to  direct  the  force  of  the 
current  into  the  carotids,  the  expulsion  of  blood  from  the 
splanchnic  cavities  by  gastric  or  intestinal  tympany,  or  over- 
loading of  the  paunch,  and  irritation  of  the  brain  by  ptomaines 
and  toxins  in  certain  infectious  diseases  (rabies,  canine  distem- 
per, etc.)  In  the  same  way  vegetable  narcotics  (opium,  etc.) 
produce  congestion.  Among  the  most  common  causes  of  con- 
gestion are  lead,  poisoning  by  lolium  temulentum,  partially  ripened 
lolium  perenue,  millet,  Hungarian  grass,  and  partially  ripened 
seeds  of  the  leguminosae  (chick  vetch,  vicia  sativa.)  Other 
causes  are  the  presence  of  tumors  (cholesteatoma)  and  parasites 
coenurus,  cysticercus)  in  the  brain. 

Symptoms,  Cerebral  hypersemia,  like  other  brain  disorders 
may  give  rise  to  a  great  variety  of  symptoms,  according  to  the 
condition  of  the  animal  and  the  susceptibility  of  its  nerve  centres. 
Some  cases  have  the  characteristic  seizures  of  vertigo,  others  the 
manifestations  of  heat  stroke,  and  others,  epileptic  explosions  or 
apoplectic  symptoms.  For  these  see  under  their  respective  head- 
ings. In  other  cases  the  symptons  are  those  of  encephalo- 
meningitisbut  moderate  in  its  type  and  often  tending  to  a  transient 
duration,  or  to  prompt  resolution  and  recovery. 

Horse.  There  is  manifest  change  of  the  nervous  and  intellect- 
ual conditions,  which  may  show  itself  by  irritability  of  restless- 
ness, by  pushing  against  the  wall,  by  hanging  back  on  the  halter, 
by  trembling,  shaking  the  head,  neighing,  payving  and,  in  ex- 
ceptional cases,  by  rearing,  biting  or  kicking.  The  pulse  is  hard 
and  full,  the  heart's  impulse  strong,  the  beats  in  the  carotids  and 
temporal  arteries  being  especially  forcible,  and  the  buccal,  nasal 
and  orbital  mucosae  are  strongly  congested.  Heat  of  the  head  is 
usually  a  marked  feature.  While  usually  very  sensitive  to  touch, 
noise  or  light,  the  animal  may  be  dull  or  drowsy,  and  in  spite  of 
its  marked  sensitiveness,  it  is  then  inert  or  lethargic  and  indis- 


92  Veterinary  Medicine, 

posed  to  any  active  exertion.  Friedberger  and  Frohner  say  that 
the  habitual  comatose  condition  alternates  at  intervals  with 
periods  of  violent  excitement  during  which  the  animal  pushes  or 
dashes  against  the  wall,  grinds  the  teeth,  rears,  paws,  kicks,  bites, 
etc.,  and  then  relapses  into  the  state  of  coma.  When  the  disease 
reaches  this  stage  it  may  be  questioned  whether  we  are  not  deal- 
ing rather  with  acute  encephalitis. 

In  active  congestion  the  symptoms  are  always  aggravated  by 
whatever  tends  to  increase  the  vascular  tension  in  the  brain. 
Active  exertion,  draught,  the  pendent  position  of  the  head,  the 
recumbent  position  on  the  side  with  the  head  as  low  as  the  body 
or  lower,  aggravate  all  the  phenomena  and  render  the  animal  more 
helpless. 

The  following  table  slightly  modified  from  Spitzka  serves  to 
point  out  the  distinctions  between  ansemia  and  hypersemia  : 


Symptoms.        j  In  Cerebral  Anaemia. 


In  Cerebral  Hypersmia. 


Usually  small  or  medium. 
Normal  or  nearly  so. 


Pupils.  I  Usually  dilated  and  mobile. 

Respiration.         \  Often  interrupted  by  a  deep 

breath  or  sigh,  even  when 

I      at  rest. 
Activity.  !  Lassitude.  Restless,  but  indisposed  to 

;  I      exertion. 

Temperament.     |  Lethargic  with  exceptions.      Irritable  with  exceptions. 
Intelligence.  Senses  impaired.  Impaired. 

Elevation  of  head!  Aggravates  symptoms.  No  effect,  or  improvement. 

Recumbent,  de-    Amelioration.  |  Aggravation. 

pendent  head. 
Straining.  I  Not  necessarily  aggravated.    Aggravated. 


Cattle  show  the  same  general  congestion  and  heat  of  the  head, 
ears  and  horns,  congested  mucosae,  fixed  eyes,  and  pupils,  indis- 
position to  follow  the  herd,  irritability,  and  dullness  with  often  a 
disposition  to  lie  down.  This  may  go  on  to  violent  bellowing, 
pushing  against  the  wall,  grinding  of  the  teeth,  working  of  the 
jaws,  rolling  of  the  eyeballs,  and  violent  dashing  in  diflFerent 
directions  regardless  of  obstacles. 

Dogs  show  the  same  restlessness  and  excitability,  congested 
head,  eyes  and  nose,  frequent  movement  from  place  to  place,  a 
desire  to  wander  off,  and  it  may  be  spasms.  If  there  has  been 
any  gastric  disturbance  vomiting  usually  supervenes.     As  in  the 


Cerebral  Hyperemia,  93 

larger  animals  the  disease  may  go  on  to  more  violent  symptoms, 
and  the  animal  howls,  rushes  in  different  directions,  and  ma}"^ 
snap  at  imaginary  objects,  or  at  any  one  who  interferes  with  him. 
His  movements  are  liable  to  be  unsteady,  uncertain  and  swaying. 

In  all  cases  the  ophthalmoscope  reveals  a  congestion  of  the 
optic  disc. 

In  the  different  animals  too,  acute  cerebral  hyperaemia  tends  to 
merge  early  into  encephalitis  with  exudation  and  pressure,  at- 
tended by  stupor,  coma,  somnolence  or  profound  lethargy. 

Treatment.  In  slight  cases  of  cerebral  hyperaemia,  it  may  be 
sufficient  to  apply  cold  to  the  head  with  a  stimulating  fomenta- 
tion to  the  limbs,  and  an  active  purgative,  with  chloral  or  bro- 
mides.    Ergot  in  full  doses  has  often  an  excellent  effect. 

In  the  more  acute  types  of  the  disease,  bleeding  is  the  first  and 
most  efficient  measure.  A  full  abstraction  from  the  jugular 
will  relieve  the  vascular  tension  and  relieve  the  circulation  on  the 
brain.  It  has  been  counselled  to  avoid  this  when  comatose 
S3rmptoms  have  set  in,  and  in  some  prostrate  conditions  a  large 
and  rapid  abstraction  of  blood  may  fatally  increase  the  prostra- 
tion. In  other  cases,  however,  the  less  rapid  abstraction  will 
improve  at  once  the  intracranial  circulation  and  nutrition,  and 
solicit  the  reabsorption  of  the  exudate  which  produces  sopor  and 
coma. 

A  purgative  is  one  of  the  most  efficient  derivatives,  the  deter- 
mination of  an  excess  of  blood  to  the  bowels  and  of  an  abundant 
serous  discharge  into  their  interior  acting  as  a  valuable  depletion, 
and  abstraction  of  blood  from  the  over-excited  brain.  At  least  a 
half  more  than  the  usual  dose  mast  be  given,  and  may  be  supple- 
mented by  an  injection  of  glycerine  or  a  hypodermic  exhibition 
of  eserine.  It  is  best  to  avoid  too  drastic  or  irritant  purgatives 
as  the  cerebral  congestion  may  be  aggravated  by  the  irritation,  as 
it  often  is  induced  in  severe  indigestions.  For  the  horse,  aloes 
and  podophyllin,  or  for  ruminants,  omnivora  and  carnivora 
castor  oil  may  be  resorted  to. 

The  patient  must  be  placed  by  himself  in  a  dark,  cool,  well 
aired  building,  and  when  able  to  resume  feeding  must  receive  an 
easily  digeste4,  non-stimulating  diet ;  for  horses  or  cattle,  gruels, 
wheat  bran  mashes,  pulped  roots,  or  green  food  ;  for  dogs  and 
pigs,  gruels,  mush  or  milk. 

Any  sequent  paralysis  must  be  treated  on  general  principles. 


MENINGO— ENCEPHAI.ITIS.     STAGGERS. 

Diviaoni.  Causes  :  traumas,  faulty  diet,  highly  nitrogenous,  leguminous 
seeds,  undergoing  ripening,  cotton  seed,  gluten  meal,  forced  feeding,  buck- 
wheat, rye  grass,  lupins,  cryptogams,  trefoil,  equisetum,  narcotics,  mi- 
crobian  ferments,  experiments  with  spoiled  food  and  epizootics  in  wet 
years,  high  temperature,  violent  exercise,  railroad  travel,  climatic  change, 
complex  causes,  embolisms,  infections,  lead,  phosphorus,  tumors,  parasites. 
Symptoms :  with  meningitis^  fever,  hypersesthesia,  active  delirium  and 
convulsions  predominate ;  with  encephcUitis^  dullness,  stupor,  somnolence, 
muscular  weakness,  anaesthesia,  paralysis,  coma  ;  usually  complex,  hyper- 
thermia, periods  of  benumbing,  followed  by  excitement ;  drowsy,  stupid, 
semi-closed  e}  el  ids,  drooping  lips,  ears,  and  head,  latter  resting  on  manger 
or  wall,  walks  unsteadily,  limbs  out  of  plumb,  hangs  on  halter,  won't  back, 
turns  in  circle,  costive,  indigestion,  tympanies,  rumbling,  abnormal  (often 
slow)  pulse  and  breathing,  congested  optic  disc  ;  alternate  with  trembling, 
excitement,  pawing,  rearing,  plunging,  pushing  against  the  wall,  trotting 
motions,  etc.  ;  uncontrollable,  violence  ;  severity  and  frequency  of  parox- 
ysms indicate  gravity  :  recovery  sequelse.  Duration  :  death  in  34  to  36 
hours  ;  or  weeks.  Prognosis  :  one  quarter  recover,  with  increased  suscepti- 
bility ;  nervous  animals  worst.  Lesions  :  extravasation,  congestion,  exu- 
dates, pus,  thickened  meninges  ;  choroid  plexus  ;  brain  matter  gray  or  red, 
puncta,  infiltrated,  softened,  excess  of  leucocytes,  red  softening,  yellow 
softening,  sclerosis,  cicatrix,  abscess.  Diagnosis  :  from  rabies,  cerebral 
congestion,  immobility,  influenza.  Cattle,  Symptoms  :  evidence  of  trauma, 
indigestion,  lead  poisoning,  narcotism,  parasitism  ;  dullness,  stupor,  somno- 
lence, stertor,  grinding  teeth,  spasms,  twitching,  restless  movements,  blind- 
ness, violent  actions,  bellowing,  hebetude,  palsy.  Relation  to  causation. 
Sheep:  Symptoms.  Swine:  Symptoms.  Dog:  Symptoms.  Diagnosis 
from  rabies.  Treatment :  quiet,  dai kness,  coolness,  restraint,  ice  or  cold 
irrigation,  elimination,  derivation,  depletion,  diuretics,  potassium  iodide, 
antipyretics,  laxative  diet,  cool  water,  evacuate  abscess.  Cattle^  similar, 
saline  laxatives,  for  lead  sulphuric  acid,  for  coenurus,  operation,  for  oestrus, 
benzine.  Dog^  parallel  treatment,  milk  diet  or  gruels,  for  lingnatula, 
benzine. 

The  inflammatory  affections  in  the  cranial  cavity  have  been 
divided  primarily  into  the  following  : 

1.  Meningitis.    Inflammation  of  the  coverings  of  the  brain,  and 

2.  Encephalitis  (  Cerebriiis).  Inflammation  of  the  nervous  sub- 
stance.    These  are  further  subdivided  into  : 

A,  Pachymeningitis,     Inflammation  of  the  dura  Mater. 

B,  Leptomeningitis,     Inflammation  of  the  pia  Mater. 

94 


Meningo — Encephalitis.     Staggers,  95 

C.  Purulent  Meningitis. 

D.  Serous  Meningitis. 

E.  Tubercular  Meningitis. 

F.  Traumatic  Meningitis,  etc. 

G.  Cef  ebro' Spinal  or  Infective  Meningitis. 
H.  Acute  Meningitis. 

/.   Chronic  Meningitis. 

J.  Polioencephalitis  Corticalis.  InHammation  of  the  brain  cortex. 

K.  Polioencephalitis  Superior.  Inflammation  of  convolutions 
around  the  Sylvian  fissure,  palsy  of  the  eyeball. 

L.  Polioencephalitis  Superior.  Inflammation  of  the  Medulla, 
bulbar  palsy. 

M.  Interstitial  Inflammation  of  the  Brain.  Resulting  often  in 
sclerosis. 

In  the  lower  animals,  however,  where  we  cannot  avail  of  sub- 
jective symptoms,  such  fine  distinctions  can  rarely  be  made  in 
diagnosis  and  except  in  case  of  an  uncomplicated  meningitis,  or 
a  circumscribed  encephalitis,  which  affects  only  a  limited  group 
of  muscles  like  those  of  the  eye,  arm,  or  leg,  we  have  to  fall 
back  upon  a  more  general  diagnosis.  Again  meningo-encepha- 
litis  is  more  common  than  the  uncomplicated  affection  of  the 
brain,  or  the  membranes,  and  therefore,  we  shall  follow  Trasbot 
in  dealing  with  the  combined  affection,  and  noting  incidentally 
the  distinctions  that  can  be  made  in  the  more  purely  limited 
affections. 

Causes.  Mechanical  Injuries.  Pachymeningitis  occasion- 
ally results  from  blows  or  other  injuries  upon  the  head,  especially 
in  stallions  and  vicious  horses  struck  with  a  heavy  whip  or  club, 
cattle  and  sheep  injured  in  fighting,  and  oxen  hurt  by  the  yoke. 
These  injuries  may  also  affect  the  brain  as  in  concussion,  or  by 
the  extension  of  the  disease  into  the  nervous  tissue.  In  the 
cranium  of  a  stallion  in  the  New  York  State  Veterinary  College 
Museum  the  whole  of  the  meninges  are  greatly  thickened  by  a 
traumatic  meningitis  of  old  date  and  the  subjacent  cerebral  con- 
volutions of  the  right  hemisphere  are  deeply  encroached  on,  flat- 
tened and  absorbed  over  an  area  of  i^  inches  in  the  longest 
•diameter. 

Diet.  Among  the  most  common  causes  of  encephalitis  in 
horses  is  an  injudicious  dietary.     Overfeeding  with  grain,    but 


96  Veterinary  Medicine. 

especially  with  grain  and  seeds  that  are  rich  in  albuminoids 
deserve  the  first  mention.  The  various  leguminous  seeds,  peas, 
beans,  tares,  vetches,  and  the  ripened  leguminous  fodders,  clover, 
alfalfa  and  sainfoin,  are  especially  to  be  incriminated.  These 
are  usually  most  dangerous  when  in  the  stage  of  advanced 
ripening  and  yet  not  fully  matured,  evidently  indicating  the 
development  of  narcotic  poison  at  this  stage.  Such  poisons  are 
found  habitually  in  certain  species,  like  the  chick  vetch  (vicia 
cicera)  which  produces  paralysis  when  fed  to  the  extent  of  more 
than  one-twelfth  part  of  the  ration.  This  danger  is  not,  how- 
ever, confined  to  the  leguminosae  ;  an  over  abundant  ration  of 
cottonseed  meal  has  a  similar  effect,  and  indeed  this  rich  ali- 
mentary product  has  been  practically  discarded  from  pig  feeding, 
and  largely  as  the  main  constituent  from  the  ration  of  dairy 
cows.  Gluten  meal,  another  product  rich  in  proteids,  is  attended 
by  similar  dangers.  But  it  is  not  alone  the  seeds  that  are  rich  in 
nitrogen  that  are  to  be  dreaded,  forced  feeding  even  on  the  car- 
bonaceous maize  induces  disorder  of  the  digestion  and  brain, 
especially  in  dairy  cows.  Buckwheat,  also,  and  indeed  all  the 
heating  carbonaceous  grains  tend  to  similar  disorders,  and  are 
especially  injurious  in  internal  ophthalmia  (recurring  ophthal- 
mia) which  is  so  closely  related  to  brain  congestion.  With 
sound  judgment  and  in  well  balanced  rations,  all  such  agents  can 
be  fed  to  advantage  ;  it  is  only  when  fed  exclusively  or  to  excess 
as  the  heavy  ration  that  they  are  to  be  feared. 

Narcotics.  Next  must  be  noted  those  alimentary  matters 
which  are  hurtful  by  reason  of  narcotic  constituents.  At  the 
head  of  this  list  may  be  placed  the  lolium  temulentum  or  intoxi- 
cating ryegrass.  Like  the  vicia  sativa  or  cicera,  the  seeds  of  this 
are  always  poisonous,  hence  its  significant  name.  Then  the 
other  ryegrasses,  perennial  and  annual  (Italian),  though  per- 
fectly safe  in  ordinary  circumstances,  develop  at  the  period  of 
ripening  a  narcotic  principle,  which  produces  cerebral  congestion 
or  inflammation  in  whole  stables  of  horses  at  a  time.  The  lolium 
temulentum  is  poisonous  to  man  and  animals  alike.  Baillet  and 
Filhol  obtained  from  the  seeds  an  etherial  extract  containing  a 
bland  oil  to  the  amount  of  two-fifths  and  a  yellow  extract  to  the 
extent  of  three-fifths.  The  amount  of  this  extract  derived  from 
three    ounces  of  the   seed   often   developed   the   most  violent 


Meningo — Encephalitis,     Staggers.  97 

symptoms  in  the  dog,  while  that  furnished  by  six  pounds  of  the 
seeds  proved  fatal  to  the  horse.  Pigs  and  cattle  seemed  to  be 
unaffected  by  the  agent  when  given  by  the  mouth.  Sheep 
suffered  more  but  required  large  doses.  Ducks  and  chickens 
were  practically  immune,  being  affected  only  by  very  large  doses. 
Rabbits  were  not  poisoned  by  the  yellow  etherial  extract,  but 
succumbed  to  a  watery  extract.  Brydon  found  that  lambs 
suffered  extensively  from  eating  the  heads  of  the  ryegrass. 

Lupins  on  certain  lands  produces  an  icteric  disorder  ac- 
companied by  cerebral  symptoms  but  the  result  is  not  the  same 
under  all  conditions  and  it  has  been  suspected  that  the  symptoms 
were  caused  by  cryptogams  and  their  products.  The  same  re- 
mark applies  to  the  brain  symptoms  sometimes  produced  by 
trefoil,  equisetum  and  other  plants. 

A  great  number  of  narcotic  and  narcotico-acrid  plants  pro- 
duce nervous  symptoms  indicating  cerebral  congestion  or  inflam- 
mation such  as  ranunculus,  wild  poppy,  digitalis,  fennel,  cenanthe 
crocata,  hellebore,  veratrum,  conium,  yew,  tobacco,  box,  aconite, 
cicuta  virosa,  even  buckwheat  at  the  time  of  flowering,  vetch  and 
flax. 

Fodders  affected  with  cryptogams  or  bacterial  ferments  are 
undoubtedly  at  times  the  cause  of  encephalitis.  Veterinary 
records  furnish  many  instances  of  wide  spread  attacks  of  stomach 
staggers,  abdominal  vertigo,  and  cerebro-spinal  meningitis  in 
wet  seasons,  when  the  fodders  have  been  harvested  in  poor  con- 
dition, or  when  from  inundation  or  accidental  exposure  they  have 
becoine  permeated  by  cr5rptogams  and  microbes.  Among  com- 
paratively recent  accounts  of  this  are  those  of  Martin  and  Var- 
nell  (musty  oats),  Irombroso,  Depre,  Erbe,  Pellizi,  and  Tireli 
(smuts),  Bouley  and  Barthelemy  (musty  fodder),  and  Ray 
(fermented  potatoes).  One  of  the  most  extended  local  out- 
breaks of  cerebro-spinal  congestion  I  have  seen,  occurred  in  the 
pit  mules  of  the  Wilkesbarre  coal  mines,  while  fed  on  Canadian 
hay  which  had  been  soaked  with  rain  in  transit  and  had  under- 
gone extensive  fermentation.  It  should  be  noted  that  there 
were  the  attendant  factors  of  overwork,  in  anticipation  of  a  strike, 
and  a  Sunday's  holiday  above  ground  in  a  bright  summer 
sunshine. 

The  experimental  administration  of  moulds,  smuts  and  mi- 
7 


98  Veterinary  Medicine, 

crobes,  have  in  the  great  majority  of  cases  led  to  little  or  no 
evil  result  (Gamgee,  Mayo,  Dinwiddie,  etc.)  and  there  is  a 
strong  tendency  to  discredit  the  pathogenic  action  of  these 
agents  in  reported  outbreaks.  The  safer  conclusion  perhaps 
would  be,  to  recognize  the  fact  that  they  are  not  equally  patho- 
genic under  all  conditions  of  their  growth  and  administrati9n. 
The  oft-recurring  epizootics  of  brain  disease  in  connection  with 
wide  spread  spoiling  of  the  fodders  in  remote  and  recent  times, 
probably  imply  that  cr5rptogams  or  microbes  and  their  products, 
plus  some  condition  not  yet  fully  understood  are  efficient  con- 
current factors.  If  we  can  discover  this  as  yet  unknown  factor 
and  demonstrate  that  it  operates  with  equal  power  in  the  ab- 
sence of  the  cryptogams  and  ferments,  as  in  their  presence,  it 
will  be  logical  to  pronounce  these  latter  as  nonpathogenic  under 
all  circumstances.  Until  then  cr5rptogams  and  bacteria  must  be 
held  as  probable  factors. 

A  continuance  of  high  temperature  is  an  undoubted  factor 
and  becomes  more  potent,  if  conjoined  with  a  close,  damp,  ill- 
aired  stable. 

Violent  exertion  especially  in  hot  weather  produces  active 
congestion  of  the  brain  and  occasionally  merges  into  meningo- 
encephalitis. If  the  animal  has  been  for  sometime  confined  to 
the  stable  on  rich  aliment  the  condition  is  aggravated. 

Railroad  travel  is  another  recognized  cause. 

Any  considerable  change  of  the  conditions  of  life  may 
operate  in  the  same  way.  A  sale  and  transport  to  a  distance 
with  change  of  feed,  water,  work,  stabling  and  even  of  cliinate 
is  at  times  a  potent  factor.  Prietsch  has  seen  a  horse  attacked 
three  times  in  a  single  year,  and  on  each  occasion  after  a  change 
of  ownership  and  locality.  Trasbot  quotes  an  Algerian  veteri- 
narian to  the  effect  that  many  of  the  Percheron  horses  imported 
into  the  Mitidja  are  attacked  by  encephalo- meningitis  during 
the  extreme  heats  of  summer. 

A  careful  observation  of  cases  will  however  show  that  in  the 
majority  of  cases  an  attack  comes  not  from  one  individual 
factor  alone  but  from  a  concurrence  of  several  operating  together. 

Other  cases  are  caused  by  embolisms  and  infections  from 
diseases  localized  in  other  parts  of  the  body.  Thus  we  have 
cerebral  abscess  in  pyaemia,  strangles  and  omphalitis,  and  cerebral 


Meningo — Encephalitis.     Staggers.  99 

congestions  and  inflammation  in  canine  distemper,  equine  con- 
tagious pneumonia,  laminitis,  and  angina. 

Among  mineral  poisons,  lead  is  notorious  as  a  cause  of  acute 
cerebral  disorder  often  leading  to  inflammation.  Other  mineral 
poisons  like  arsenic  and  phosphorus  may  lead  to  encephalitis 
symptomatic  of  gastro  intestinal  irritation,  or  caused  by  the  toxic 
products  of  indigestion. 

Rapidly  growing  tumors,  like  cholesteatomata,  are  liable  to 
induce  recurrent  attacks  of  encephalitis  in  connection  with 
periodic  irritation. 

Finally  parasites  in  the  cranium  are  sufficient  causes  of  at- 
tacks. In  the  New  York  State  Veterinary  College  Museum  is  the 
brain  of  a  cat  with  a  nematoid  wound  round  the  h3rpophysis.  In 
equine  subjects  suffering  from  the  strongylus  armatus  the  larval 
worm  or  dots  caused  by  its  presence  in  other  arteries  sometimes 
invade  the  encephalic  blood  vessels  causing  disturbances  of  the 
circulation,  embolism,  inflammation  or  degeneration.  (  Albrecht, 
Von  Heill;.  The  larvae  of  the  cestrus  has  also  been  found  in  the 
bndn  substance  producing  inflammatory  or  degenerative  fod 
(Briickmtiller,  Megnin,  Siedamgrotzky).  Thdr  presence  in  the 
nasal  sinuses  at  times  causes  encephalitis  by  oontig^ty.  The  ces- 
toid worms,  CGenurus  in  sheep  and  other  ruminants,  and  c>'sti- 
cercus  in  swine,  find  their  natural  larval  habitat  in  the  brain  and 
by  thdr  movements  produce  more  or  less  congestion  and  inflam- 
mation. Cases  of  ccenurus  in  the  horse  have  been  described  by 
Rousset,  Frenzd,  Zundel,  and  Schwanefeldt. 

Symptoms.  The  symptoms  of  uncomplicated  meningitis  on  the 
one  hand  and  encephalitis  on  the  other  are  rarely  seen,  the 
disease  usually  implicating  more  or  less  both  brain  and  meninges, 
in  a  common  inflammation  or  the  s\-mptoms  of  the  one  invoh-ing 
those  of  the  other  through  proximity  or  interdependence  of  func- 
tion. And  yet  in  traumatic  lesions  of  the  cranial  walls,  the 
symptoms  may  be  those  of  pure  meningitis,  and  in  thrombosis, 
embolism  or  parasitism  of  the  brain,  and  in  certain  tumors  they 
may  be  those  of  simple  encephalitis.  The  distinction  consists 
largely  in  the  predominance  of  fever,  h^-peraesthesia,  active  de- 
lirium and  convulsions  in  meningitis,  and  especially  in  its  earlier 
stages:  and  the  prominence  of  dullness,  stupor,  somnolence,  mus- 
cular weakness,  paralysis,  anaesthesia,  coma,  and  the  clouding  of 
^ledal  senses,  with  much  less  pronounced  febrile  reaction,  or 
vascular  exdtement  in  encepluditis. 


loo  Veterinary  Medicine, 

There  is  usually,  however,  a  mixing  of  symptoms  so  that  the 
benumbing  or  paralysis  of  the  nervous  functions  alternates  with 
periods  of  their  exaltation,  and  with  both  conditions  h3rperther- 
mia  exists,  though  usually  higher  with  meningitis. 

The  manifestations  of  benumbing  or  paresis  may  be  continu- 
ous or  interrupted,  and  are  exhibited  in  stupor,  coma,  somnolence, 
lethargy,  paresis  or  paralysis.  The  manifestations  of  excitement 
are  not  continuous  but  occur  in  paroxysms  or  at  least  exacerba- 
tions, which  may  show  in  visual  or  mental  illusions,  active,  vio- 
lent delirium,  trembling,  rigors,  clonic  or  tonic  spasms.  The 
onset  is  usually  abrupt,  the  animal  passing  in  a  few  hours  from 
apparent  health,  to  pronounced  nervous  disorder.  The  horse 
seems  drowsy  and  stupid,  standing  with  semi-closed  eyes,  often 
drooping  lower  lip  and  ears,  head  pendent  and  resting  in  the 
manger  or  against  the  wall  in  front,  the  back  arched  and  the 
limbs  drawn  together.  When  moved,  it  walks  unsteadily  and  often 
the  limbs  are  left  out  of  plumb,  one  extending  unduly  forward, 
backward  or  to  one  side,  and  often  crossing  over  its  fellow.  Some 
cannot  be  made  to  back,  others  back  spontaneously  hanging  on 
the  halter.  Turning  short  in  a  circle  is  difficult  or  impossible 
and  tends  to  throw  the  patient  down.  Yet  some  exceptional 
cases  will  turn  around  spontaneously  to  the  right  or  left,  and  an 
animal  tied  to  a  post  goes  around  it  at  the  end  of  its  halter  in  its 
effort  to  pass  straight  forward.  The  circling  movement  may  be 
due  to  the  irritation  on  the  one  side  of  the  brain  or  to  irritation  of 
particular  ganglia  and  nervous  tracts  as  noticed  under  cerebral 
hyperaemia. 

Appetite  is  usually  lost,  or  more  properly,  the  animal  no 
longer  takes  notice  of  surrounding  things,  not  even  of  its  food. 
In  some  cases,  however,  in  which  stupor  or  coma  is  not  extreme 
the  animal  will  eat  a  little  during  his  quiescent  intervals.  In 
ryegrass  and  other  dietetic  poisoning,  the  animal  may  still  eat  and 
fall  asleep  with  the  mouth  full.  The  digestion  is  impaired  or 
suspended,  the  bowels  costive,  and  fermentations  with  tympanies 
and  rumbling  are  frequent  complications.  When  originating  from 
poisonous  food  this  often  contributes  to  these  abdominal  compli- 
cations. 

Respirations  in  the  comatose  condition  are  deep  and  slow, 
sometimes  not  more  than  four  or  five  per  minute.     The  heart 


Meningo — Encephalitis,     Staggers,  loi 

usually  beats  strongly,  often  tumultuosly,  and  the  pulse  varies 
greatly — ^infrequent  or  frequent,  strong  or  weak,  full  or  small. 
With  cerebritis  it  is  often  abnormally  slow. 

H)rperthermia  is  always  present  to  a  greater  or  less  extent, 
being  often  more  marked  in  the  more  violent  forms  or  those  in 
which  meningitis  appears  to  predominate  than  in  the  purely  cere- 
bral forms.     The  temperature  may  vary  from  ioi°  to  io6°. 

The  optic  disc  is  congested. 

Probably  in  all  cases  or  nearly  all  there  is  a  preliminary  stage 
of  excitement,  in  which  the  eye  is  clear,  the  eyelids  open,  the 
aspect  alert  and  the  whole  skin  affected  by  a  marked  h)rper- 
sesthesia.  In  some  cases  the  symptoms  of  excitement  are  much 
more  violent  at  the  outset  of  the  disease,  as  marked  by  trembling, 
nervous  movements,  pawing,  pushing  the  head  against  the  wall 
while  the  motions  of  walking  or  trotting  are  performed  by  the 
limbs,  ot  those  of  plunging  forward,  rearing  up,  drawing  back 
on  the  halter,  etc. 

But  even  when  the  disease  seems  to  have  started  with  stupor 
and  coma,  these  paroxysms  of  excitement  almost  invaribly  ap- 
pear at  intervals  as  it  advances.  Some,  however,  plunged  in 
stupor  or  coma  at  the  first,  remain  in  this  condition  until  they 
end  in  paralysis  or  death,  or  start  in  convalescence. 

During  one  of  the  paroxysms  the  trembling  animal  may  push 
his  head  against  the  wall  as  if  pulling  a  heavy  load  ;  at  other 
times  he  will  plunge  with  his  feet  in  the  manger  and  recoiling, 
fall  to  the  ground,  where  he  struggles  violently  in  an  apparent  ef- 
fort to  rise  ;  others  rear  up,  pulling  on  the  halter  or  breaking  it 
and  falling  back  over  ;  some  pull  back  on  the  halter  and  throw 
themselves  down  ;  some  grind  the  teeth,  or  seize  the  manger,  or 
strike  blindly  with  the  fore  limbs.  When  seized  out  of  doors 
the  horse  may  be  quite  uncontrollable  and  refuse  to  return  to  the 
stable  even  when  led  by  two  men  with  double  halters.  In  all 
such  cases  the  eye  has  a  fixed,  glaring  aspect  which  is  the  more 
pronounced  when  the  pupils  are  dilated,  the  conjunctiva  is 
deeply  congested,  of  a  deep,  brownish  red  with  a  tinge  of  yellow. 
This  is  usually  greatly  enhanced  by  the  bruises  and  extravasa- 
tions caused  by  pushing  or  knocking  the  head  against  the  wall. 
The  same  violence  may  lead  to  serious  bruises  and  injuries  else- 
where, even  fractures  of  the  orbital  process  or  zigoma,  of  the 


I02  Veterinary  Medicine, 

ilium  or  ischium,  of  the  poll  or  the  base  of  the  brain  ;  also  of  the 
incisor  teeth. 

These  paroxysms  may  be  so  frequent  that  they  seem  to  be  sub- 
ject to  remissions  only,  and  not  separated  by  complete  intermis- 
sions. During  the  paroxysms  breathing  and  pulsations  are  both 
greatly  accelerated. 

The  gravity  of  the  attack  may  be  judged  in  part  by  the  vio- 
lence and  frequency  of  the  paroxysms.  Yet  some  cases,  marked 
by  profound  coma  from  the  first,  prove  the  most  rapidly  fatal, 
and  the  paroxysms  of  excitement  and  violence  are  not  incompat- 
ible with  recovery.  Improvement  may  usually  be  recognized  by 
the  increased  length  of  the  intervals  between  the  paroxysms,  and 
by  the  shortening  and  moderation  of  the  periods  of  excitement. 
After  the  paroxysms  have  ceased  the  drowsiness  or  stupor  gradu- 
ally disappears,  and  the  hyperthermia  subsides. 

Even  after  recovery  from  the  acute  or  violent  symptoms  there 
is  liable  to  remain  some  aberration  or  perversion  of  function,  due 
to  the  persistence  of  some  encephalic  or  meningeal  lesion.  The 
general  hebetude  known  as  immobility  may  bespeak  dropsy  of 
the  ventricles,  pressure  of  a  tumor  or  clot,  or  degeneration  of 
ganglonic  centres.  Diseases  of  the  eyes  (amaurosis,  glaucoma, 
cataract),  or  of  the  ear  (deafness,  disease  of  the  internal  or 
middle  ear)  are  less  frequent  results. 

The  supervention  of  general  or  facial  paralysis  or  of  hemi- 
plegia during  the  active  progress  of  the  malady,  is  an  extremely 
unfavorable  symtom. 

Duration,  A  fatal  result  may  take  place  at  any  time  by  self 
inflicted  injuries  (dashing  the  head  against  the  wall,  or  falling 
backward  and  striking  the  head  on  a  solid  body).  Apart  from 
this,  death  may  come  within  twenty- four  or  thirty-six  hours.  If 
the  animal  survives  two  to  seven  days  recovery  is  more  probable. 
Hering  records  a  case  of  recovery  after  five  weeks  illness.  Hot 
weather  hastens  a  fatal  result,  while  cool,  cloudy  weather  is 
favorable. 

Prognosis,  Under  rational  treatment  about  one-fourth  recover. 
One-half  of  the  victims  make  a  partial  recovery  but  remain  in  a 
condition  of  dementia  or  hebetude,  blindness,  deafness,  local  or 
general  paralysis  which  renders  them  more  or  less  useless.  Not 
more  than  one-fifth  or  at  most  one-fourth  of  all  cases  recover. 


Meningo — Encephalitis,     Staggers.  loj 

Even  in  these  there  is  left  an  increased  predisposition  to  re- 
currence.  It  is  noted  by  Trasbot  that  the  mortality  is  higher  in 
highbred,  nervous,  irritable  animals,  which  show  a  tendency 
to  greater  frequency,  force  and  duration  of  the  paroxysms  of  ex- 
citement. When  decubitus  is  constant,  death  may  take  place 
from  septic  poisoning  starting  from  bed  sores,  and  gangrenous 
sloughing.  In  other  cases  there  is  fatal  starvation  from  inability 
to  eat. 

Lesions.  In  pachymeningitis  due  to  mechanical  injury  there 
is  usually  cutaneous  and  subcutaneous,  blood  extravasation,  and 
there  may  be  fracture  of  the  cranial  bones.  The  dura  matter  is 
dark  red,  hyperaemic,  thickened,  covered  with  exudation  and  small 
blood  clots  mixed  with  pus  cells,  and  has  contracted  strong  ad- 
hesions to  the  cranial  bone.  Bony  spicula  may  project  into  the 
fibrous  neoplasm. 

Leptomeningitis  usually  coexists  from  extension  of  the  in- 
flammation into  the  adjacent  arachnoid  and  pia  mater.  There 
is  then  a  reddish  serous  effusion  into  the  arachnoid  and  beneath 
it,  and  the  substance  of  both  membranes  is  thickened  by  exudate, 
and  discolored  by  congestion  and  minute  haemorrhages.  When- 
ever the  pia  mater  is  thus  inflamed,  the  superficial  layer  of  the 
brain  is  implicated,  oedematous,  soft  and  doughy.  The  exten- 
sion is  also  made  into  the  ventricles  and  a  serous  effusion  takes 
place  often  to  two,  three  or  more  times  the  normal  amount 
(82  grammes,  Schiitz).  The  choroid  plexus  forms  a  yellowish 
gelatinoid  mass,  and  the  ganglia  (corpora  striata,  optic  thalamus, 
etc.),  are  flattened. 

In  encephalitis  the  affected  superficial  gray  matter  of  the 
ganglia  or  convolutions,  is  deepened  in  color,  usually  in  limited 
areas  corresponding  to  the  disease  of  the  meninges.  Sometimes 
the  color  becomes  of  a  distinctly  reddish  tinge,  and,  when  cut  into, 
shows  unusually  prominent  red  points  where  the  capillaries  have 
been  cut.  Somewhat  larger  areas  of  blood  staining  indicate  haemor- 
rhagic  extravasations.  The  nervous  substance  is  more  or  less 
infiltrated  with  liquid  and  softened.  The  nerve  cells  are  swollen, 
and  in  process  of  granular  degeneration  and  the  same  is  true  of 
the  myelin,  while  the  axis  cylinder  is  uneven  in  its  outline. 
Apart  from  the  numerous  minute  petechial  haemorrhages  there  is 
an  abundant  migration  of  leucocytes  which  are  found  scattered  in 
the  degenerating  and  softened  nervous  tissues. 


I04  Veterinary  Medicine, 

The  softening  of  the  nervous  tissue  may  result  in  a  pulpy 
material,  which  in  the  comparative  absence  of  blood  is  grayish 
(gray  softening),  if  abundantly  infiltrated  with  blood  is  red 
(red  softening),  if  older  and  discolored  is  yellow,  as  in  an  old 
extravasation  (yellow  softening),  if  thick  and  viscous  is  gc- 
latinoid  softening.  If  the  exudate  becomes  organized  into 
fibrous  material  it  is  a  connective  tissue  sclerosis  or  a  cica- 
trix. If  the  softening  exudate  becomes  purulent  it  constitutes 
a  cerebral  abscess.  Cerebral  abscess  is  especially  common  as 
secondary  abscess  in  strangles  or  contagious  rhino-adenitis  in  the 
horse,  but  may  occur  as  the  result  of  the  presence  of  any  pyo- 
genic germ. 

Diagnosis,  'While  there  is  a  certain  similarity  to  rabies,  the 
horse  with  encephalo-meningitis  is  distinguished  by  the  absence 
of  the  extreme  h3rperaesthesia  and  irritability,  of  the  persistent 
neighing  and  squealing,,  of  the  rapid  alterations  of  the  voice, 
hoarse  and  shrill,  of  the  hallucinations,  as  following  imaginary 
objects  with  the  eyes,  of  the  readiness  to  attack  with  teeth  or 
heels  when  in  any  way  disturbed  or  excited,  of  the  disposition  to 
get  violently  excited  when  a  dog  is  brought  near,  or  in  the  case 
of  a  stallion  to  show  generative  excitement. 

From  cerebral  congestion  it  is  to  be  distinguished  by  the 
greater  severity  of  the  paroxysms,  or  the  deeper  character  of  the 
stupor,  but  above  all  by  the  presence  of  the  hyperthermia  and 
other  indications  of  fever. 

Immobility  which  presents  the  symptoms  of  drowsiness, 
stupor  and  hebetude,  is  also  unattended  by  fever,  or  anorexia, 
shows  a  healthy  condition  of  the  functions  of  respiration,  diges- 
tion and  assimilation  and  a  restful  condition  when  left  quiet 
and  .still. 

The  cerebral  excitement  that  sometimes  appears  in  influenza  is 
really  an  encephalitis  complication,  but  its  specific  cause  is 
recognized  in  the  local  prevalence  of  the  infectious  disorder,  and 
the  inflammatory  or  catarrhal  condition  of  the  mucous  membranes. 

The  diagnostic  manifestations  of  meningitis  and  encephalitis 
respectively  are  given  under  symptoms. 

Symptoms  in  Cattle.  In  cattle  encephalo-meningitis  super- 
venes on  congestion,  and  sometimes  comes  on  abruptly  in  con- 
nection with  traumatic  injuries,  acute  gastric   disorder,    lead- 


Meningo — Encephalitis,      Staggers.  105 

poisoning,  or  narcotism.     The  cases  of  cerebral  parasitism  are 
usually  slow  in  their  onset. 

Upon  the  preliminary  dullness  and  somnolence  there  super- 
venes excitement,  manifested  by  loud  bellowing,  pushing  the 
horns,  forehead  or  teeth  against  the  wall,  labored  often  stertorous 
breathing,  a  fixed  eye  often  with  dilated  pupil  giving  it  a  peculiar 
glaring  appearance,  movements  of  the  jaws,  frothing  at  the  lips, 
tremors,  muscular  spasms,  twitching,  or  a  restless  disposition  to 
move,  in  a  circle,  in  a  straight  line  or  less  frequently  backward. 
The  patient  seems  to  see  nothing  and  is  utterly  regardless  of  ob- 
stacles. Sometimes  the  animal  plunges  violently  into  manger 
or  rack,  against  or  through  the  partition  of  his  box,  through 
fences,  into  ponds,  pits,  quarries  and  other  dangerous  places  that 
may  be  accidentally  in  his  way.  The  paroxysms  may  be  inter- 
mitted by  intervals  of  comparative  calm,  and  tend  to  merge  into 
a  condition  of  dulled  sensation,  staggering,  stupor,  hebetude  and 
paralysis.  The  congested  conjunctiva  and,  when  it  can  be  seen, 
the  optic  disc  will  correspond  to  the  cerebral  congestion.  These 
cases  usually  proceed  to  a  fatal  issue  in  a  few  hours.  Some 
cases,  however,  make  a  good  recovery  after  a  few  days  of  dull- 
ness and  prostration.  In  cases  that  are  connected  with  lead 
poisoning,  or  the  toxic  action  of  narcotics  in  the  fodder,  the  at- 
tendant circumstances  will  assist  in  the  diagnosis.  From  malig- 
nant catarrh  implicating  the  encephalon,  it  may  be  distinguished 
by  the  absence  of  the  catarrhal  inflammation  of  the  conjunctiva, 
pituita,  sinuses,  buccal  mucous  membrane,  and  genito-urinary 
passages.  Also  of  the  tendency  to  implication  of  the  hair  follicles 
and  the  keratogenous  tissue  of  the  frontal  horns. 

In  the  Edinburgh  Veterinary  Review^  Dundas  describes  a  form 
of  alcoholism  in  cows  caused  by  feeding  these  animals  on  '*  burnt 
ales*'  in  the  vicinity  of  distilleries.  The  ale  is  given  by  steeping 
straw  in  it,  and  the  animals  will  also  drink  it  freely.  They  often 
sleep  soundly  after  such  a  beverage  or  give  evidence  of  intoxica- 
tion. The  head  is  turned  singularly  to  one  side  and  slightly  ele- 
vated. The  pupils  are  widely  dilated,  and  the  eyes  have  a  re- 
markably wild  appearance.  On  being  approached  the  animals 
wink  rapidly  and  tremble.  There  is  marked  heat  of  head,  horns, 
and  ears.  When  pressed  with  the  finger  in  the  axilla  they  fall 
instantly  and  when  pulled  by  the  head  they  incline  to  turn  over. 


io6  Veterinary  Medicine. 

The  pulse  is  70  to  80  per  minute.  Delirium  and  loss  of  coordi- 
nation of  the  muscular  movements  set  in,  and  in  case  of  survival 
various  forms  of  chronic  brain  disease  are  manifested.  In  one 
cow  the  violent  symptoms  came  on  with  the  near  approach  of 
parturition.  The  post  mortem  lesions  consisted  in  ramified  red- 
ness and  punctiform  blood  extravasations  in  the  pia  mater  and 
meninges.  The  brain  substance  was  softened  and  clots  of  blood 
were  found  in  the  lateral  ventricles.  Congestion  and  extravasa- 
tions were  also  found  around  the  cervical  myelon.  (See  Alco- 
holic Intoxication.) 

Symptoms  in  Sheep,  The  sheep  is  often  drowsy,  dull  and 
stupid,  lying  by  itself  with  head  low  or  laid  backward.  During^ 
the  periods  of  excitement  it  works  the  jaws,  froths  at  the  mouth, 
carries  the  head  turned  in  one  direction,  upward  or  lateral^ 
bleats .  piteously,  pushes  against  the  wall,  has  uncertain, 
stiff  or  staggering  gait,  or  convulsions,  and  finally  paralysis. 
The  head  is  hot,  and  the  eye  fixed,  congested  or  sometimes 
rolled  upward  or  squinted.  Symptoms  in  the  goat  are  nearly 
the  same.  The  coenurus  disease  is  more  gradual  in  its  onset, 
and  produces  periodic  paroxysms  corresponding  to  the  activity 
of  the  heads  of  the  parasite  when  protruded  into  the  brain 
substance.  It  is  mainly  confined  to  sheep  of  one  year  and 
under  and  that  are  kept  where  dogs  have  access. 

Symptoms  in  Swine,  Pigs  may  at  first  have  a  period  of  dull- 
ness or  restlessness,  the  latter  merging  into  active  delirium.  The 
patient  champs  his  jaws,*  froths  at  the  mouth  and  nose,  some- 
times vomits,  squeals,  raises  himself  with  fore  feet  on  the  wall, 
walks  round  and  round,  or  falls  and  rolls  over,  has  tremors  or 
convulsions. 

Symptoms  in  the  Dog,  There  may  be  preliminary  indications 
of  illness,  anxiety,  restlessness,  irritability  and  a  desire  for  seclu- 
sion. Vomiting  may  occur.  This  is  liable  to  merge  into  pros- 
tration, a  dullness  of  the  special  senses,  utter  inattention  to  calls, 
yet  a  disposition  to  resent  any  interference,  a  readiness  to  bite,  at 
least  to  howl,  when  handled.  Some  will  constantly  howl  or 
moan.  The  eye  is  fixed,  the  pupils  dilated,  the  conjunctiva  deep 
red,  the  head  and  roots  of  the  ear  are  hot.  The  expression  of 
the  face  is  pinched  and  drawn,  the  muscles  may  twitch,  the  eyes 
roll,  twitching  of  the  neck  or  limbs  may  appear,  and  even  epilep- 


Meningo — Encephalitis,     Staggers,  '  107 

tiform  attacks.  In  exceptional  cases  the  symptoms  approximate 
to  those  of  rabies,  in. the  tendency  to  seek  seclusion,  to  wander 
ofF,  to  bite  on  any  interference,  and  even  to  gnaw  the  bars  of  the 
cage  or  any  object  within  reach.  After  more  or  less  of  such  ex- 
citement, the  period  of  stupor,  coma,  paresis,  or  paralysis  comes 
on,  and  the  animal  dies  in  a  state  of  complete  nervous  prostra. 
tion.  In  cases  associated  with  the  linguatula  taenioides  the 
sneezing,  nasal  discharge  and  nasal  congestion,  even  in  the  early 
stages,  betray  the  true  character  of  the  disorder. 

The  rabiform  cases  usually  lack  the  intense  irritability,  the 
deep  conjunctival  congestion,  the  depraved  appetite,  the  al- 
teration of  the  voice,  and  the  mischievous  desire  to  attack 
without  reason  which  characterize  rabies. 

Treatment,  In  all  cases  of  phrenitis,  quiet,  darkness,  and 
coolness  are  especially  demanded.  For  the  horse  a  roomy,  loose 
box  or  a  well  fenced  yard  may  be  secured,  and  if  he  can  be  se- 
cured by  a  halter  from  a  point  above  the  level  of  the  head  and  in 
the  centre  of  the  box  it  will  obviate  the  increase  of  congestion  by 
hanging  of  the  head.  The  application  of  cold  to  the  cranium  in 
the  form  of  wet  cloths,  ice  bags  or  irrigation  is  always  in  order, 
and  should  be  continued  so  long  as  heat  of  the  head  and  other 
indications  of  cranial  h3rperaemia  last. 

In  the  horse  suffering,  as  is  so  often  the  case,  from  narcotic 
poisoning  an  active  purgative  is  one  of  the  first  considerations  to 
clear  away  any  remains  of  the  poison  from  the  prima  viee.  An 
ounce  of  aloes  may  be  safely  given,  as  there  is  in  this  case  little 
danger  of  superpurgation,  and,  to  secure  an  even  more  prompt 
response,  eserine  ( i  j4  grain)  or  barium  chloride  (^  drachm)  may 
be  given  subcutem  or  intravanously.  Or  an  ounce  or  two  of 
glycerine  by  the  rectum  might  be  used  as  a  substitute  for  these 
last.  The  action  of  the  purgative  proves  not  only  eliminant  and 
therefore  antidotal,  but  it  is  a  most  eflFective  derivative  from  the 
brain.  When  the  restlessness  or  excitement  is  very  great  we 
may  use  acetanilid,  trional,  sulphonal  or  some  one  of  the  many 
brain  sedatives  and  antithermics.  Sedatives,  or  anodynes  like 
opium,  which  tend  to  increase  cerebral  congestion  are  dangerous. 

Bleeding  from  the  jugular  or  temporal  artery,  has  been  objected 
to  ou  the  ground  that  it  tends  to  increase  the  exudate  and  there- 
fore the  pressure  and  cerebral  anaemia.     On  the  other  hand  it 


io8  Veterinary  Medicine, 

often  proves  of  great  value  in  vigorous,  muscular  and  plethoric 
horses  in  temporarily  lessening  the  blood-pressure  in  the  brain, 
and  afiFording  the  walls  of  the  overcharged  capillaries  an  oppor- 
tunity to  resume  a  more  normal  tone  and  to  control  that  very 
exudation  which  is  so  much  dreaded.  It  is  most  efiPective  in  the 
early  stages  when  little  or  no  exudation  has  taken  place  and  may 
then  be  pushed  to  the  extent  of  producing  a  perceptible  softening 
of  the  pulse  (4,  6  or  8  quarts).  Even  in  the  advanced  stages 
when  exudation  has  led  to  stupor  or  coma  a  moderate  and  care- 
fully guarded  bleeding  may  favor  reabsorption  of  the  liquid  exu- 
date. In  weak  and  ansemic  cases  in  which  general  bleeding  ap- 
pears to  be  contra-indicated  the  shaving  of  the  cranial  surface 
followed  by  leeching  or  wet  cupping  can  be  safely  resorted  to. 

Counterirritants  like  bleeding  are  denounced  and  advocated  by 
diflEerent  practitioners.  In  cases  of  extreme  h3rperaesthesia  where 
excitement  and  fever  would  be  dangerously  increased  by  their 
use,  they  must  be  discarded,  or  used  only  in  the  modified  form 
of  soothing  hot  fomentations  to  the  extremities.  Where  there 
is  less  sensitiveness  mustard  poultices  or  pulp  applied  on  the  sides 
of  the  neck,  or  upon  the  limbs,  or  even  more  energetic  blisters 
will  be  of  great  service. 

After  the  action  of  the  purgative  the  bowels  may  be  kept  free 
by  calomel  in  yi  drachm  doses  twice  daily  and  as  much  sulphate 
of  soda  as  may  be  necessary. 

Iodide  of  potassium  ( 1-2  drs.  twice  a  day)  is  beneficial  as 
an  antithermic,  a  circulatory  sedative,  an  eliminant,  and  probably 
at  times  as  an  antidote  but  it  cannot  be  given  while  calomel  is 
used.  Certain  it  is  that  it  often  seems  to  act  well  in  succession 
to  the  purgative,  in  cases  of  poisoning  by  ryegrass  and  legu- 
minosae. 

When  fever  runs  very  high  it  may  sometimes  be  admissible 
to  give  aconite,  but  the  coal  tar  products  are  much  more  prompt 
and  powerful,  and  may  therefore  be  more  hopefully  employed 
for  a  short  time. 

In  conditions  of  extreme  prostration,  stupor,  or  coma,  stimu- 
lants are  resorted  to,  but  too  often  with  no  good  effect,  the 
exudation  and  compression  which  many  times  cause  such  symp- 
toms being  rather  aggravated  than  benefited  by  such  agents. 

During   convalescence  a  restricted,    non-stimulating   laxative 


Meninga — Encephalitis,     Staggers  109 

diet  (bran  mashes,  gruels,  apples,  potatoes,  carrots)  is  de- 
manded.    Pure  cool  water  should  be  always  accessible. 

In  other  forms  of  meningo-encephalitis  the  same  general  prin- 
ciples should  be  applied,  due  attention  being  paid  to  the  re- 
moval of  the  active  cause  when  that  can  be  discovered. 

When  the  indications  point  unequivocally  to  abscess,  and  its  seat 
can  be  accurately  located  by  a  circumscribed  paralysis,  an 
operation  for  its  evacuation  is  fully  warranted.  Otherwise  death 
or  permanent  uselessness  is  almost  certain. 

In  cattle  and  other  ruminants  the  same  general  principles  of 
treatment  must  be  applied.  As  a  cathartic  Epsom  or  Glauber 
salts  are  preferred  to  aloes  and  may  be  supplemented  by  barium 
chloride  or  eserine.  Croton,  sometimes  useful,  is  liable  to 
dangerously  increase  the  gastric  irritation  in  cases  in  which  this 
is  a  marked  determitiing  factor.  When  the  animal  is  down, 
raise  the  head  by  bundles  of  straw,  or  by  a  halter  tied  to  a 
beam  overhead.  In  lead  poisoning,  sulphuric  acid  largely  diluted 
may  be  added  to  the  sulphates  so  as  to  precipitate  the  insoluble 
sulphate  of  lead.  Potassium  iodide  is  of  value  to  dissolve  the 
lead  in  the  tissues  and  lead  to  its  elimination.  Cases  of  coenurus 
require  trephining  and  extraction  ;  the  larvae  of  the  oestrus  should 
be  washed  out  with  tobacco  water  or  destroyed  by  benzine. 

In  dogs  the  stomach  is  usually  emptied  spontaneously  by 
emesis.  A  purgative  of  castor  oil,  followed  by  daily  doses  of 
calomel  may  be  given,  and  attention  given  to  the  cooling  of  the 
head  and  general  system.  Antipyrin  or  acetanilid  may  be  use- 
fully employed.  The  diet  should  be  restricted  to  milk  or  thin, 
well-boiled  gruels. 

The  linguatula  in  the  nose  must  be  met  as  are  the  oestridae  of 
the  sheep,  and  intestinal  worms  must  be  got  rid  of  by  active 
vermifuges. 


CHRONIC  HYDROCEPHALUS.     DROPSY  OF  THE  VEN- 
TRICLES.    IMMOBILITY. 

Horse  especially  suffers.  Enzootic  in  ji^ven  Alpine  Valleys,  along  Rhone, 
in  Miwissippi  Valley  and  bottom  lands.  Acclimatizing  fever.  Old, 
lymphatic,  large  heads,  narrow  foreheads  predisposed.  Geldings.  Causes, 
heredity,  cerebral  and  meningeal  congestion,  cranial  traumas,  venous  ob- 
struction, tumors,  false  membranes,  fodder  or  water  poisoning,  overwork, 
insolation,  prolonged  moist  heat,  hepatic,  gastric,  and  pulmonary  disorders 
Symptoms:  form  of  head,  stupid  expression,  irresponsive  ears,  pendent 
lips,  sluggish  movements,  crossed  legs,  slow  mastication,  dips  face  in  water, 
intractable  by  halter  or  rein,  unable  to  back  with  rider,  or  wagon,  drags 
back  fore  limbs,  worst  in  hot  damp  wtather,  in  sunshine,  or  after  work,  or 
with  full  stomach.  Paroxysms  of  excitement.  Lesi  >ns :  excess  of  arach- 
noid, subarachnoid  or  ventricular  fluid,  atrophy  of  ganglia  and  convolu- 
tions, ependyma  thick,  opaque,  sclerosis,  brain  ansemic.  Tumors,  nature. 
Kxperimental  cases  Prognosis,  incurable,  better  in  cool  season.  In  cattle, 
sheep,  swine  and  dogs.  Treatment:  derivatives,  nerve  stimulants  (nux), 
puncture,  pilocarpin,  purgatives.  Jurisprudence.  Notify  seller  in  9  days 
(France),  15  (Bavaria),  21  (Wurtenberg,  Baden),  28  (Hesse,  Prussia),  30 
(Aufttria).     Examination  by  expert. 

Dropsy  of  the  ventricles  is  common  in  the  horse  in  certain 
countries  and  districts,  yet  even  there  it  is  uncommon  in  cattle, 
sheep,  swine  and  dogs,  save  as  a  congenital  affection.  It  is  re- 
ported as  enzootic  in  some  Alpine  valleys  and  along  the  Rhone, 
attacking  especially  the  mares  and  immature  horses  so  that  breed- 
ing becomes  impossible.  Mauener  who  reports  this  says  that  in 
the  same  localities  encephalic  diseases  are  more  common  in  man. 
In  America  it  appears  to  be  most  frequent  in  the  rich  bottom 
lands  of  the  Mississippi  valley  and  of  the  Southern  States. 
Northern  horses  taken  to  the  Gulf  States  though  they  may  not 
suffer  to  this  extent,  are  liable  in  the  first  year  to  show  weakness, 
debility,  and  lack  of  vigor  which  is  spoken  of  as  the  acclima- 
tizing fever.  Elsewhere  the  affection  is  one  of  the  old  horses  in 
which  the  vital  powers  begin  to  fail.  Common  breeds  of  horses 
with  lymphatic  temperament,  large  head  and  narrow  forehead 
have  been  found  to  be  especially  predisposed.  Geldings  are  said 
to  be  most  liable  on  account  of  the  arrested  development  of  the 
brain,  but  with  the  great  preponderance  of  geldings  among  work 
horses,  it  is  dangerous  to  generalize  too  far. 
no 


Chronic  Hydrocephalus,     Dropsy  of  the  Ventricles.  1 1 1 

Causes.  Acute  encephalitis  may  lapse  into  the  chronic  form  and 
then  assume  the  symptoms  of  this  disease.  Cases  that  come  on 
slowly  and  imperceptibly  appear  at  times  to  be  hereditary,  as 
might  be  expected  from  the  fact  that  it  usually  goes  with  a 
lymphatic  temperament.  The  conditions  which  cause  cerebral  or 
meningeal  hyperaemia  in  chronic  form  conduce  to  the  affection. 
Injuries  to  the  cranial  vault  from  traumatism  or  disease  are  infre- 
quent causes.  Renault  records  a  case  associated  with  two  bony  tu- 
mors, each  as  large  as  an  egg,  projecting  inward  from  the  frontal 
bone  and  which  had  produced  extensive  absorption  of  the  convolu- 
tions and  increase  of  the  cerebro  spinal  fluid.  In  a  case  of  my 
own  with  an  abscess  in  the  diploe  above  the  frontal  sinus,  and 
pressing  inward  on  the  brain  a  similar  condition  existed.  In 
other  cases  Renault  noticed  that  the  cerebro  spinal  fluid  was 
largely  in  excess. 

Much  more  commonly,  however,  the  accummulation  of  liquid 
takes  place  in  the  ventricles,  and  is  associated  with  different 
causes  :  as  tumors  or  false  membranes  near  the  base  of  the  brain 
pressing  on  the  veins  returning  blood  from  the  ependyma,  tumors 
in  the  ventricles  (cholesteatomata,  etc.,  of  the  ependyma  or 
<!horoid  plexus)  obstructing  the  circulation  or  giving  rise  to  local 
hyperaemia,  and  chronic  congestions  from  the  other  causes  such 
as  faulty  conditions  of  fodders,  or  water,  exposure  to  undue  heat, 
overwork,  etc.  The  enzootic  prevalence  of  the  disease  in  certain 
localities,  (Alps,  Rhone  Valley,  bottom  lands)  would  suggest  that 
local  conditions  in  food  or  water  are  factors,  though  we  cannot  as 
yet  fully  explain  the  mode  of  causation.  In  the  same  way  we 
must  recognize  the  influence  of  hepatic  and  gastric  disorders 
which  arise  from  such  faulty  regimen  and  affect  the  brain  by 
nervous  sympathy  and  by  the  action  of  toxic  elements  thrown 
into  the  circulation.  Then  again  we  must  take  sufficient  ac- 
count of  the  congestions  resulting  from  obstructions  in  the 
lesser  circulation,  disease  of  the  lungs,  and  of  the  right  heart, 
and  compression  of  the  jugulars  by  a  tight  or  badly  fitting 
collar,  or  compulsory  curving  of  the  neck  as  set  forth  under 
vertigo  and  cerebral  congestion. 

Symptoms.  Among  the  symptoms  must  be  recognized  the 
conformation  with  which  it  is  usually  found  associated.  The 
predisposed  animals  are  usually  low  bred,  common  horses,  with 


112  Veterinary  Medicine, 

narrowness  of  the  cranium  and  space  between  the  ears  and 
with  a  retreating  of  the  head  from  the  orbits  to  the  poll.  Other 
horses  suffer  but  the  majority  are  of  this  conformation,  and  thus 
the  disease  acquires  a  hereditary  basis. 

The  expression  of  the  face  is  characteristic.  The  eye  is  dull, 
often  sunken,  lacking  in  vivacity  and  life,  the  eyelids  are 
semi-closed,  the  ears  do  not  prick  up  to  sounds,  the  muscles  of 
the  face  are  relaxed,  so  that  the  lips  hang  flaccid,  and  the  nostrils 
fail  to  dilate  freely  and  rhythmically.  The  animal  is  apparently 
unconscious  of  all  that  goes  on  around  him,  and  is  not  aroused 
by  the  entry  or  exit  of  men  or  horses,  by  voice  or  slap,  by 
food  or  water.  His  head  is  probably  dropped  and  resting  in 
the  manger,  and  he  raises  it  sluggishly  when  compelled  ;  when 
moved  from  side  to  side  cf  the  stall  his  legs  may  retain  a 
position  turned  outward  or  crossed  one  over  the  other  ;  if  ener- 
getically roused  he  wakes  up  slowly,  and  almost  immediately 
relapses  into  his  former  lethargy,  without  accomplishing  what 
was  called  for.  When  left  with  legs  crossed  he  often  remains  so 
until  wearied  by  the  constrained  position,  or  in  danger  of  falling 
from  loss  of  balance.  Not  only  the  legs  but  the  head  will  re- 
tain for  a  time  an  abnormal  position  given  to  it, — ^bent,  dropped, 
turned  to  one  side  or  the  other. 

This  same  lethargy  extends  even  to  mastication,  which  is  usu- 
ally performed  slowly  and  indifferently,  and  is  often  interrupted 
in  the  middle  of  the  trituration  of  a  morsel  which  remains  in  the 
cheek,  on  the  tongue,  or  between  the  teeth,  and  perhaps  hanging 
out  of  the  mouth.  Hence  the  horseman's  expression,  he  smokes 
his  pipe. 

His  mode  of  drinking  is  no  less  singular.  Usually  the  lower 
part  of  the  face  is  dropped  deeply  into  the  water,  and  he  will  only 
withdraw  it  when  it  becomes  necessary  to  breathe.  He  may  con- 
tinue to  masticate  while  drinking. 

When  walked  or  trotted  he  may  move  a  short  distance  all  right ; 
he  may  even  hasten  his  progress  for  a  short  distance  without 
refusing  meanwhile  to  respond  to  the  rein,  then  he  may  stop 
and  for  a  short  time  longer  resist  all  efforts  with  voice,  whip,  or 
spur  to  start  him  anew.  In  other  cases  he  will  turn  to  one  side, 
getting  into  ditches  or  fences  by  an  apparently  involuntary  action 
and  in  defiance  of  whip  or  reins. 


Chronic  Hydrocephalus,     Dropsy  of  the  Ventricles,  113 

One  of  the  most  striking  features  of  the  disorder  is  the  difficulty 
of  backing.  In  some  cases  he  will  back  a  few  steps  and  then  prove 
unable  to  back  farther  ;  in  others  he  will  show  it  best  when  heat- 
ed with  a  jonmey  ;  in  other  cases  still  he  will  back  well  enough 
under  his  own  weight,  but  prove  utterly  unequal  to  the  act  if  a 
heavy  man  is  placed  on  his  back,  or  if  hitched  to  a  loaded  wagon. 
In  backing  with  or  without  a  rider  the  horse,  pulled  back  by  the 
reins,  inclines  backward  with  his  hind  limbs  extended  forward 
beneath  the  abdomen,  his  forefeet  extended  in  front,  and  his  back 
arched  ;  he  extends  his  head  or  turns  it  to  one  side,  and  when  the 
change  in  the  center  of  gravity  endangers  his  equilibrium,  he 
draws  back  his  forefeet  without  lifting  them,  each  making  a 
groove  in  the  ground,  and  at  the  same  time  he  makes  a  disorderly 
motion  of  the  hind  limbs  to  one  side  to  restore  the  balance.  In 
default  of  this  he  may  drop  his  quarter  on  the  ground  and  perform 
a  back  somersault  on  his  rider.  Even  when  he  succeeds  in  bal- 
ancing himself  after  dragging  the  forefeet  back,  the  difficulty  of 
further  backing  is  rather  increasied,  as  the  nervous  irritability  is 
enhanced  by  a  continuance  of  the  excitement. 

When  hitched  in  a  carriage  the  phenomena  are  virtually  the 
same  ;  when  backed  he  extends  or  flexes  the  head,  inclines  the 
body  backward,  and  after  a  time  loses  his  equilibrium,  sometimes 
executes  a  few  disorderly  steps  backward,  or  throws  himself  vio- 
lently tp  one  side,  or  turns  over  backward  in  the  shafts. 

The  symptoms  are  always  worse  during  hot,  damp  weather,  and 
when  the  animals  are  exposed  to  the  full  glare  of  the  sun.  The 
milder  cases  can  be  worked  without  great  inconvenience  in  winter, 
while  they  become  utterly  useless  in  summer. 

Active  exertion  and  increased  rapidity  of  the  circulation  has  a 
similarly  injurious  effect.  After  a  period  of  rest  nothing  amiss 
may  be  noticed,  while  after  a  period  of  work  in  the  sunshine  the 
symptoms  become  well  marked  and  the  difficulty  of  backing  pro- 
nounced. Plethora  or  full  feeding  aggravates,  while  spare,  laxa- 
tive diet,  laxatives,  rest  or  bleeding  relieves. 

The  affection  may  become  complicated  by  more  active  inflam- 
matory action  leading  to  paroxysms  resembling  those  of  meningo- 
encephalitis ; — pushing  against  the  wall,  rearing  up  with  the  fore 
feet  in  the  manger,  acting  as  if  walking  or  trotting,  etc.  In 
other  cases  the  paroxysms  resemble  those  of  vertigo ;  the  animal 
8 


1 1 4  Veterinary  Medicine, 

plunging  forward,  starting  to  one  side,  or  rearing  up  and  falling 
back. 

Lesions,  The  pathological  anatomy  of  this  disease  is  that  of 
chronic  hydrocephalus.  Renault  records  cases  in  which  the  sub- 
arachnoid and  arachnoid  fluids  were  under  the  normal  while  the 
fluid  in  the  ventricles  was  increased  to  a  marked  extent.  This 
accumulation  is  often  so  great  that  the  whole  of  the  surrounding 
nervous  matter  is  greatly  attenuated,  the  convolutions  of  the 
cerebral  hemispheres  are  flattened  so  that  the  sulci  are  all  but  ef- 
faced, the  water  may  shine  through  at  points  and  even  bulge 
after  the  manner  of  a  hernia,  the  ganglia  in  the  ventricle  (corpus 
striatum,  optic  thalamus,  hippocampus)  are  flattened  and  atro- 
phied, the  base  of  the  cerebrum  is  thinned  and  bulges  downward, 
and  the  olfactory  lobes  may  have  their  internal  cavity  greatly 
distended  so  that  they  look  like  little  bladders  of  fluid.  The 
ependyma  may  have  lost  its  normal  thinness  and  translucency, 
having  become  thick  and  opaque,  and  sometimes  its  surface  is 
granular  and  rough.  The  choride  plexus  is  congested  and 
swollen  with  infiltration.  The  brain  tissue  adjacent  is  firmly  ad- 
herent and  there  is  a  h5^rplasia  of  its  connective  tissue  consti- 
tuting a  veritable  sclerosis.  At  some  points,  however,  the  com- 
pressed nervous  tissue  has  undergone  degeneration  and  softening. 
As  might  be  expected  from  the  pressure  of  the  liquid,  anaemia  of 
the  brain  tissue  is  a  marked  feature  of  the  morbid  condition. 

Other  conditions  have  at  times  been  found  in  chronic  hydro- 
cephalus. 

Renault  found  two  long  tumors  each  as  large  as  a  hen's  egg 
projecting  from  the  dura  mater  into  the  cerebral  hemisphere.  In 
other  cases  there  have  been  fibrous  thickening  of  the  dura  mater, 
exudations  on  the  pia  mater,  and  false  membranes  on  the  arach- 
noid (Roll).  Chabert  and  more  recent  writers  have  observed 
cysts  and  tumors  of  the  choroid  plexus  in  such  cases,  but  these 
have  been  met  with  not  unf requently  in  the  entire  absence  of  the 
characteristic  symptoms  of  this  disease. 

Nature,  The  affection  before  us  is  evidently  one  in  which  the 
majority  of  the  higher  brain  functions  are  profoundly  depressed 
or  debilitated,  and  this  is  accounted  for  by  the  accumulating 
intraventricular  liquid  pressing  on  the  ganglionic  centres  in  the 
cerebral  hemispheres,  and  in  the  floor  of  the  lateral  and  third 
ventricles. 


Chronic  Hydrocephalus,     Dropsy  of  the  Vetitricles.         115 

Bxperimentally  an  approximate  loss  of  sensation,  intelligence, 
spontaniety,  will,  and  muscular  power  is  produced  in  birds  or 
mammals  deprived  of  their  cerebral  hemispheres.  Colin*s  heifer, 
which  had  been  thus  mutilated,  would  lie  in  torpor,  and  though 
it  could  be  made  to  get  up  and  walk,  it  struck  its  head  heedlessly 
against  the  wall,  and  retained  in  its  mouth  unchewed,  the  food 
that  had  been  placed  there.  He  says  of  such  cases  :  *  *  they  live 
a  long  time,  move  automatically,  respire,  digest,  but  they  lose, 
with  the  sensations,  memory,  judgment,  will,  and  the  most  vital 
instincts  of  their  kind.'* 

In  the  dropsy  of  the  ventricles  the  attenuation  and  atrophy  of 
the  cerebral  convolutions  produce  symptoms  which  approximate 
closely  to  those  resulting  from  their  experimental  ablation,  so 
that  one  may  fairly  attribute  the  general  symptoms  in  the  two 
cases  to  the  loss  of  their  function.  Many  of  the  attendant  symp- 
toms, and  especially  the  aberration  of  smell,  sight,  hearing  and 
taste,  may  be  referred  to  the  concomitant  injuries  of  the  basal 
ganglia  of  the  brain. 

We  need  not  seek  in  one  general  answer  to  resolve  the  question 
whether  the  dropsy  or  inflammation  is  the  initial  lesion.  For  our 
present  purpose  it  must  suffice,  that  the  dropsy  with  anaemia  and 
atrophy  of  the  cerebral  convolutions  and  basal  ganglia  produce 
the  symptoms  of  immobility. 

At  the  same  time  it  is  only  logical  to  conclude  that  any  morbid 
condition  of  the  cerebral  circulation  or  of  the  brain  or  membranes 
which  leads  to  a  corresponding  amount  of  ventricular  effusion,  or 
atrophy  or  destruction  of  the  nerve  centres,  already  designated, 
will  produce  the  symptoms  characteristic  of  this  disease.  Thus 
the  diflFerent  forms  of  meningitis,  traumatic  injuries  to  the 
cranium,  chronic  encephalitis,  cerebral  softening  or  degeneration, 
sclerosis,  neoplasms  of  all  kinds  affecting  the  brain,  (cysts,  choles- 
teatoma, psammoma,  melanoma,  etc.),  and  parasites  may  occasion 
this  disease. 

Prognosis,  The  disease  is  essentially  incurable.  It  may  last 
for  years  with  little  change  except  the  winter  improvement,  but  it 
rarely  subsides  permanently.  It  is  only  in  those  cases  in  which 
the  symptoms  have  been  determined  by  a  transient  or  removable 
cause,  as  a  moderate  exudation  or  a  parasite  with  a  short  term  of 
life  that  a  favorable  result  may  be  looked  for.     Usually  the  im- 


1 1 6  Veterinary  Medicine, 

provements  seen  in  cool  seasons  or  stables,  under  good  hygiene, 
are  not  recoveries  but  temporary,  amelioration  only. 

Symptoms  in  other  animals.  Corresponding  conditions  produce 
similar  symptoms  in  cattle,  sheep,  swine  and  dogs,  but  the  disease 
receives  less  attention  in  these  animals  because  they  are  not  called 
on  for  steady  work.  The  animals  are  lazy,  dull,  insensible  to 
excitement,  stupid,  show  a  lack  of  muscular  power  and  control, 
stagger  or  move  disorderly  and  show  tympanies  or  other  indica- 
tions of  indigestion. 

Treatment,  Majendie  and  others  had  a  few  apparent  recoveries 
after  violent  counter-irritation  over  the  spinal  cord  (cervical  and 
dorsal).  Coculet  and  Lafosse  claimed  recoveries  from  the  pro- 
longed use  of  nux  vomica  in  large  doses  (up  to  5  drachms). 
Hayne  attempted  evacuation  of  the  fluid  by  puncture  through  the 
perforated  plate  of  the  ethmoid  bone,  but  had  evil  results  from 
the  ensuing  haemorrhage  and  encephalitis.  Aseptic  puncture 
through  the  plate  of  the  frontal  bone  would  be  much  more  prom- 
ising. Klemm  suggested  hydrochlorate  of  pilocarpin  (15  grains) , 
and  this  would  promise  better  than  any  other  measure  to  induce 
absorption  of  the  liquid.  The  fatal  drawback  to  this  as  to  other 
measures  is  that  it  is  not  applied  until  the  slow,  steady  pressure 
has  caused  such  extensive  cerebral  atrophy  that,  even  if  the  liquid 
could  be  removed  and  its  reproduction  prevented,  the  lost  func- 
tions can  never  be  restored.  If  the  disease  could  be  diagnosed 
and  treated  before  this  change  of  structure  had  taken  place,  the 
hope  of  recovery  would  be  much  better  founded.  Even  in  cases 
which  make  a  temporary  recovery  during  cold  weather  one  would 
be  warranted  in  using  active  derivatives  toward  the  bowels  and 
kidneys,  also  pilocarpin,  counter-irritation  to  the  spine  and  even 
tapping  of  the  ventricles. 

Legal  Aspect  of  Chronic  Hydrocephalus. 

To  claim  relief  in  case  a  horse  afiFected  in  this  way  is  sold  as 
sound,  the  seller  mftst  be  notified  at  an  early  date.  InthediflFer- 
ent  countries  of  Europe  a  limit  is  set  after  which  such  notification 
will  have  no  legal  value.  The  seller  must  be  notified,  in  France 
in  9  days,  in  Saxony  in  15  days,  in  Bavaria,  Wurtenberg  and 
Baden  in  21  days,  in  Hesse  and  Prussia  in  28  days,  and  in  Austria 
in  30  days. 


Chronic  Hydrocephalus.     Dropsy  of  the  Ventricles.         117 

Diagnosis.  The  veterinarian  called  to  act  as  expert  in  such 
cases  must  examine  the  suspected  animal  along  the  different  lines 
in  which  the  cerebral  aberration  is  manifested  in  the  disease.  He 
will  see  the  animal  standing  quietly  in  the  stall  apart  from  all 
sources  of  excitement.  See  if  there  is  a  defect  in  the  breadth  of 
the  cranium,  or  a  deflection  backward  of  this  region  from  the 
straight  line  of  the  front  of  the  face,  together  with  a  heavy  clumsy 
head.  Is  the  head  pendent,  resting  on  the  manger,  with  dull  eye, 
drooping  lids,  lack  of  expression,  loose  hanging  lower  lip?  Does 
he  hold  morsels  unchewed  projecting  from  the  mouth  or  over  the 
tongue,  or  in  the  cheek  ?  Does  he  plunge  both  mouth  and  nose 
in  the  water  to  drink,  and  masticate  meanwhile  ?  Are  his  legs 
found  crossed  or  in  abnormal  positions,  and  if  put  in  such  posi- 
tions, does  he  fail  to  rectify  them  at  once  ?  Is  the  head  left  in  an 
abnormal  flexed,  depressed  or  lateral  position  if  placed  in  it  ? 
Does  the  subject  find  it  difficult  or  impossible  to  back  ?  Does  he 
pay  the  customary  attention  to  the  going  or  coming  of  other 
horses,  to  feeding,  etc.  ? 

If  no  distinct  s3rmptoms  are  found  he  should  then  be  examined 
under  other  conditions.  In  taking  out  of  the  stable  how  does  he 
turn  in  the  stall  or  back  out  of  it,  and  in  what  way  does  he 
approach  the  door,  clumsily  or  with  difficulty  ?  When  moved  in 
a  circle,  does  he  sway  or  stagger  ?  Can  he  back  when  mounted 
or  attached  to  a  heavy  carriage  ?  Can  he  execute  all  these  move- 
ments satisfactorily  after  the  respiration  and  circulation  have  been 
excited  by  walking,  trotting  or  galloping  in  hand  or  otherwise? 
In  case  of  difficulty  in  backing,  in  the  absence  of  the  other  diag- 
nostic symptoms,  he  must  see  that  this  does  not  arise  from  other 
causes.  Some  untrained  horses  have  not  been  taught  to  back  and 
cannot  be  made  to  do  so  at  once.  Some  refuse  to  back  from  in- 
docility  or  stubbornness,  but  can  perform  the  act  if  induced  in 
other  ways,  as  in  having  a  narrow  stall.  Sometimes  a  sore  mouth, 
from  a  hard  bit  may  make  a  horse  nervous  and  obstinate  so  that 
he  will  seek  to  escape  in  any  other  way  rather  than  by  backing 
under  steady  pressure  of  the  bit.  Sometimes  he  will  back  all 
right  under  the  halter.  In  all  such  cases  of  simple  obstinacy  or 
fear  of  jKun,  the  absence  of  the  other  symptoms  is  strongly  sug- 
gestive. If  the  horse  has  a  well  developed  cranium,  a  full  bright, 
alert  eye,  firmness  of  lips,  intelligent  expression,  readiness  to 


Ji8  Veterinary  Medicine, 

appreciate  and  respond  to  all  noises,  words,  touches  or  other 
causes  of  excitement,  plenty  of  fire  and  spirit,  and  an  absence  of 
any  apathy,  dullness,  awkwardness  of  movement  or  position  of  the 
limbs,  or  of  any  other  sign  of  failing  nervous  power  he  may  be 
considered  free  from  this  afiFection,  even  if  he  refuses  to  back  in  a 
docile  manner.  In  other  cases  there  is  a  distinct  physical  inca- 
pacity quite  apart  from  any  brain  disorder.  Sprains  or  anchy- 
losis of  the  back  or  loins  or  anchylosis  or  painful  arthritis  of  the 
hocks,  may  hinder  backing. 

The  diagnosis  from  e^ncephalitis  and  other  inflammatory  affec- 
tions associated  with  stupor,  rests  on  the  absence  of  h5^rthermia, 
of  the  congestion  of  the  orbital  and  nasal  mucosae,  of  the  heat  of 
the  head  and  of  the  paroxysmal  attacks  of  excitement  which  char- 
acterize these  diseases. 


CEREBRO-SPINAL  MENINGITIS. 

Definition.  Epizootic  manifestations.  Faulty  hygiene,  insanitary  stables, 
impure  air,  defective  drainage,  fermenting  food,  overwork,  overfeeding,  ex- 
citement, heat  exhaustion,  electric  tension.  Probably  complex.  Horse, 
ox,  sheep,  goat,  dog.  Microbian  factors  in  man  and  rabbit.  Lesions : 
meningeal,  brain  and  spinal  congestion,  effusion,  suppuration,  circumscribed 
necrosis,  softening,  petechis.  Blood  dark,  fluid  or  a  diffluent  clot.  Symp- 
toms :  horse :  paresis,  anorexia,  dysphagia,  mucous  congestion,  reddish 
brown  :  in  severe  cases,  chill,  stupor,  apathy,  debility j  palsy,  tonic  spasms 
of  neck,  back  or  loins,  hypereesthesia,  twitching,  trismus,  hyperthermia, 
delirium,  coma,  convulsions,  and  early  death.  Duration  averages  7  to  15 
days.  Ox,  as  in  encephalo-meningitis.  Sheep,  microbes.  Do^,  dulled 
senses,  stupor,  coma,  palsy,  hyperthermia,  heat  of  head,  spasms,  etc.  Diag- 
nosis :  by  brain  and  spinal  symptoms ;  cases  in  groups.  More  sudden  than 
tetanus,  or  rabies,  and  shows  no  mischievous  purpose,  nor  depraved  appe- 
tite :  from  tubercular  meningitis.  .  Treatment :  Avoid  suspected  stable, 
food,  water,  or  supicious  environment,  disinfect,  correct  local  diseases, 
unload  bowels,  belladonna,  atropia,  chloral,  bromides,  ergot,  phenacetin, 
potassium  iodide.  Bleeding.  Cold  to  head  or  back.  Derivatives.  Sling. 
In  convalescence,  regulated  diet  and  tonics. 

Definition,  Concurrent  inflammation  of  the  meninges  of  the 
brain  and  spinal  cord. 

This  appears  at  times  in  many  horses  in  the  same  locality,  as  in 
New  York  in  1850  (Large),  in  Denmark  since  1852  (Stockfleth, 
Bagge),  and  in  Egypt  in   1876  (Apostolides).      In   Cairo  alone 


Cerebrospinal  Meningitis  119 

about  6,000  horses,  mules  and  donkeys  perished.  Hence  the 
disease  is  known  as  epizootic  cerehros  pinal  meningitis.  But  again 
it  is  often  seen  in  scattering  or  sporadic  cases.  Add  to  this  that 
no  evidence  has  ever  been  adduced  that  the  disease  is  communi- 
cated from  one  animal  to  another,  and  in  these  days  of  the  par- 
allelism of  epizootics  and  pathogenic  microbes,  we  may  well 
hesitate  about  continuing  to  use  such  a  qualifying  term.  Fried- 
berger  and  Frohner  claim  **  that  a  large  number  of  clinical  facts 
have  been  erroneously  reported  under  the  name  of  spasms  of  the 
neck.  Rabies,  tubercular  basilar  meningitis,  apoplexy,  simple 
encephalitis,  and  certain  poisonings  have  been  confounded  with 
that  disease.  ' '  They  assure  us  that  *  *  cold,  damp,  chilly  weather, 
hot  stables,  clipping  and  overfeeding  are  of  but  secondary  im- 
portance," but  they  fail  absolutely  to  tell  us  what  is  ol  primary 
importance  in  a  causative  sense.  American  writers  who  have 
attempted  to  account  for  the  disease  have  groped  somewhat 
blindly  for  causes  in  the  idea  of  poison.  Large  charged  it  on  in- 
sanitary conditions,  poisonous  gases,  and  defective  sewerage  in 
cities,  and  lack  of  drainage  and  deficient  stable  ventilation  in  the 
country.  J.  C.  Michener  attributes  it  to  foods  undergoing  fer- 
mentation and  considers  it  as  a  paralysis  due  to  toxic  fungi.  W. 
L.  Williams,  in  Idaho,  found  the  greatest  number  of  cases  in 
winter  had  been  fed  hay  made  from  alfalfa  (lucerne)  and 
timothy,  though  some  had  small  grains  and  native  grasses.  The 
soil  was  dry,  porous,  gravelly,  devoid  of  humus,  and  lying  on 
lava  rock.  The  altitude  and  clearness  of  the  atmosphere  were 
supposed  to*  exclude  the  idea  of  cryptogams,  yet  the  crops 
generally  were  raised  by  irrigation.  The  water  was  from  clear 
mountain  streams.  Stables  were  generally  low  and  full  of 
manure,  with  thatched  roofs,  but  hardly  tight  enough  to  be 
called  close.  In  these  cases  the  defective  stable  room,  the  irriga- 
tion, the  leafy  hay  (lucerne),  and  the  probable  presence  of  fer- 
ments (bacteria),  are  the  only  suggestive  conditions.  In  a  fatal 
outbreak  which  I  saw  among  the  Wilkesbarre,  Pa.,  pit  mules, 
rain-soaked  and  badly  fermented  timothy  hay,  overwork  in  view 
of  a  strike,  and  a  Sunday's  holiday  in  an  unshaded  yard  under  a 
hot  July  sun,  in  contrast  with  the  previous  darkness  and  coolness 
of  the  pits,  coincided  to  disturb  the  general  health.  In  several  of 
the  Southern  States  it  is  attributed  to  worm-eaten  com.     Trum- 


I20  Veterinary  Medicine, 

bower  thinks  it  should  be  traced  to  the  parasitic  fungi  that  grow 
on  plants,  grains,  and  vegetation.  In  many  instances  the  disease 
has  appeared  simultaneously  with  the  feeding  on  certain  speci- 
mens of  brewer's  grains,  oats  and  hay,  so  that  to  use  Trum- 
bower's  words  these  were  the  carriers  if  not  the  prime  factors  of 
the  disease. 

In  recognizing  how  much  cryptogams  and  bacteria  vary  under 
diflFerent  conditions  of  life,  and  what  various  products  they  elab- 
orate at  diflFerent  stages  of  their  growth,  we  can  theoretically  ex- 
plain the  absence  of  the  disease  at  one  time  and  its  presence  at 
another  under  what  seem  to  be  identical  circumstances,  as  also 
the  variety  of  symptoms  shown  in  diflFerent  outbreaks.  While 
this  causation  cannot  be  said  to  be  absolutely  proved,  it  is  not 
antagonistic  to  the  facts  in  many  of  the  best  observed  outbreaks, 
and  may  serve  as  a  h3rpothetical  working  theory  until  actual 
demonstration  can  be  furnished.  The  aflFection  suggests  a  nar- 
cotic poison  introduced  from  without,  rather  than  a  disease  due 
to  a  germ  propagated  in  the  system. 

This  need  not,  however,  exclude  the  operation  of  attendant 
conditions  such  as  over  work,  plethoric  feeding,  excitement,  close 
stables,  heat  exhaustion,  etc.,  which  tend  to  bring  about  cerebro- 
spinal congestion.  Even  the  electric  tension  of  Idaho,  of  the 
United  States  generally,  and  of  Egypt,  in  connection  with  their 
comparatively  dry  atmosphere,  should  not  be  overlooked  in  con- 
sidering the  possible  causative  factors. 

In  all  probability  as  we  learn  more  of  the  true  pathology  of  the 
disease,  we  shall  come  to  recognize  not  one,  but  several  toxic 
principles,  and  several  diflFerent  aflfections  each  with  its  character- 
istic phenomena  in  the  somewhat  indefinite  aflFection  still  known 
as  cerebro-spinal  meningitis. 

The  malady  has  been  described  in  horses,  oxen,  sheep,  goats 
and  dogs,  attacking  by  preference  the  young,  which  are  not  yet 
inured  to  the  unknown  poison,  and  by  preference  in  winter  and 
spring,  the  periods  of  close  stabling,  dry  feeding  and  shedding  of 
the  coat. 

In  the  absence  of  bacteriological  data  from  the  horse,  it  maybe 
noted  that  in  man  cerebro-spinal  meningitis,  has  been  commonly 
found  to  be  associated  with  the  presence  in  the  meningeal  exudates 
oi  th^  micrococcus  pneumonia  crauposa^  (Micrococcus  lanceolatus 


Cerebrospinal  Meningitis  121 

encapsulatus).  This  is  frequent  in  the  mouths  of  healthy  per- 
sons so  that  some  additional  accessory  cause  must  be  invoked  to 
increase  the  susceptibility  or  lessen  the  protective  power  of  the 
tissues.  This  has  been  thought  to  be  found  in  the  concurrent 
presence  of  other  bacteria,  the  staphylococcus  pyogenes  aureus, 
pneumobaccillus  of  Priedlander  and  the  streptococcus  pyogenes. 
Mosny  appears  to  have  established  this  for  the  staphylococcus  in 
the  case  of  rabbits.  With  a  given  dose  of  the  micrococcus  pneu- 
moniae death  was  always  delayed  for  a  fortnight,  while  with 
the  same  dose  thrown  into  one  thigh,  and  the  staphylococcus 
aureus  in  the  other,  the  rabbit  died  in  one  day.  This  enhanced 
potency  resulting  from  the  presence  of  the  golden  staphylococcus 
has  been  invoked  to  account  for  the  germ  making  its  way  from 
the  mouth  to  the  brain  in  cases  of  otitis,  suppuration  of  the 
Eustachian  tube,  tonsilitis  or  nasal  catarrh.  These  remarks  are 
intended  to  be  suggestive,  rather  than  conclusive,  as  we  have 
as  yet  no  certainty  that  cerebro-spinal  meningitis  in  the  horse 
is  caused  by  the  same  germ  as  it  is  in  man. 

Lesions,  The  lesions  are  usually  those  of  leptomeningitis,  or 
congestion  of  the  brain  and  spinal  cord  and  often  eflFusion  into 
the  ventricles,  with  a  serous  exudation  under  the  pia  mater  or 
into  the  arachnoid  cavity.  This  may  be  transparent  and  yel- 
lowish, or  grayish  and  turbid,  or  milky.  In  the  sheep,  Roloff 
has  found  purulent  products  under  the  pia  mater,  around  the 
roots  of  the  spinal  nerves,  and  in  the  surface  layers  of  cerebral 
gray  matter.  The  marked  hyperaemia  on  the  surface  of  the 
gray  matter  is  a  striking  feature,  and  circumscribed  areas  of  ne- 
crotic nervous  tissue  and  softening  are  not  uncommon.  Pete- 
chiae  are  frequent  on  the  meninges,  the  brain,  heart,  lungs  and 
kidneys.  Granular  and  fatty  degenerations  are  also  met  with  in 
these  parenchymatous  organs.  The  blood  may  be  dark  and 
liquid  or  diffiuent. 

Symptoms  in  the  Horse.  The  mildest  attacks  are  manifested 
by  paresis,  or  loss  of  perfect  control  over  the  limbs,  or  loss  of 
power  over  the  tail,  impairment  of  appetite  and  some  diflSculty  of 
swallowing,  together  with  some  congestion  or  reddish  brown  dis- 
coloration of  the  orbital  and  nasal  mucosae.  In  other  cases 
paralysis  of  one  or  more  limbs  may  supervene  but  without 
marked  fever  or  coma. 


122  Veterinary  Medicine, 

The  more  severe  forms  are  ushered  in  by  violent  trembling,  or 
by  stupor,  apathy,  and  extreme  muscular  weakness,  or  actual 
paralysis.  In  such  cases  the  animal  may  stagger  or  fall.  Dys- 
phagia or  inability  to  swallow  is  often  a  marked  s5rmptom,  the 
saliva  falling  in  strings  from  the  lips.  Another  common  phe- 
nomenon is  the  rigid  contraction  of  the  muscles  of  the  neck,  back 
and  loins,  the  parts  becoming  tender  to  the  touch  and  a  more  or 
less  prominent  oposthotonos  setting  in.  Twitching  of  the  mus- 
cles of  the  shoulders  and  flanks  may  be  noticed.  Trismus  also 
is  sometimes  seen.  The  breathing  is  usually  rapid  and  catch- 
ing and  the  temperature  104°  to  106°.  The  pulse  may  be  ac- 
celerated and  hard,  or  weak  and  soft,  or  alternating.  The  eyes 
are  violently  congested,  of  a  brownish  or  yellowish  red  color, 
and  the  eyeballs  may  be  turned  to  one  side.  Paroxysms  of  de- 
lirium may  set  in,  when  the  animal  will  push  against  the  wall, 
or  perform  any  of  the  disorderly  movements  described  under 
meningo-encephalitis.  Sooner  or  later  coma  and  paralysis  super- 
vene, and  death  occurs  in  from  five  to  forty-eight  hours.  In  the 
most  acute  (fulminant)  cases  the  animal  falls  and  dies  in  convul- 
sions. On  an  average  the  disease  lasts  from  eight  to  fifteen  days. 
In  the  more  favorable  cases,  without  any  supervention  of  coma, 
recovery  may  begin  on  the  third  or  fourth  day. 

Symptoms  in  the  Ox.  These  are  largely  those  of  encephalo- 
meningitis.  If  they  do  not  come  on  with  the  customary  violence, 
there  may  be  at  first  difficulty  in  prehension,  mastication  and 
swallowing  of  food  ;  a  rigid  condition  of  the  muscles  of  the  neck, 
back,  and  sometimes  of  the  jaws,  and  twitching  of  the  muscles  of 
the  limbs,  neck,  lips,  or  eyes.  For  a  time  there  may  be  hyperaes- 
thesia,  restlessness  and  irritability,  stamping  of  the  feet  or  shaking 
of  the  head,  then  there  is  liable  to  follow,  dullness,  apathy,  stupor, 
coma  and  paralysis.  As  in  the  horse,  the  distinction  from  ordi- 
nary encephalo-meningitis  will  at  times  rest  on  the  prevalence  of 
the  epizootic  disease  in  the  locality. 

Symptoms  in  Sheep.  The  attack  is  described  as  coming  on 
with  weakness,  dullness,  lethargy,  salivation,  convulsions,  opos- 
thotonos, grinding  of  the  teeth,  succussions  of  the  body  and 
limbs,  heat  of  the  head,  and  stupor  or  paralysis  unless  death 
ensues  during  a  paroxysm.  The  congestion  of  the  head  and  of 
the  encephalic  mucous  membranes,  and  the  deviation  of  the  eyes 


Cerebrospinal  Meningitis.  123 

are  constant  features.  Wischnikewitsch  describes  an  extended 
outbreak  in  sheep  in  which  the  brain  lesions  were  complicated  by 
hepatization  of  the  lungs,  and  bacilli  were  found  in  the  various 
exudates.  This  reminds  one  of  the  presently  accepted  cause  in 
man,  which  is,  however,  a  micrococcus  rather  than  a  bacillus. 

Symptoms  in  Dogs.  These  are  described  as  some  aberration 
of  the  senses,  which  gradually  merges  into  stupor,  coma  and 
paralysis.  While  the  animal  is  able  to  keep  on  his  feet  he  sways 
and  staggers,  runs  unconsciously  against  objects,  or  walks  in  a 
circle.  There  is  heat  of  the  head,  injected  eyes,  sometimes 
drawn  back  or  squinting,  oposthotonos,  and  general  spasms  oc- 
curring in  paroxysms.  The  duration  of  the  disease  is  about  the 
same  as  in  the  horse. 

Differential  Diagnosis.  From  other  forms  of  meningitis  this  is 
easily  distinguished.  Fulminant  cases  almost  all  belong  to  this 
type,  the  fact  of  the  coincident  implication  of  brain  and  spinal 
cord  is  strongly  suggestive  of  this  form,  and  the  occurrence  of 
many  cases  at  once,  without  any  demonstrable  toxic  or  thermic 
cause,  is  tolerably  conclusive.  From  tetanus  there  is  this  added 
distinction,  that  the  disease  does  not  set  in  so  slowly,  the  spasms 
of  the  neck  and  back  are  not  so  persistent,  and  stupor  sets  in 
early,  in  a  way  that  is  unknown  in  lockjaw.  Rabies  is  recognized 
by  the  slow  onset,  the  characteristic  prodromata,  the  mischievous 
disposition,  the  depraved  appetite,  and  by  the  history  of  its  local 
prevalence.  Tubercular  meningitis  in  cattle  has  a  similar  asso- 
ciation with  tuberculous  animals  in  the  same  family  or  herd,  and 
often  by  the  local  indications  of  tubercle  elsewhere,  emaciation, 
unthriftiness,  cough,  flbcculent  and  gritty  nasal  discharge,  en- 
larged lymph  glands,  pharyngitis,  mammary  disease. 

Treatment.  With  a  disease  so  iatal  prevention  should  be  the  first 
consideration  and  especially  when  it  appears  in  an  enzootic  form. 
Even  in  the  absence  of  a  definite  knowledge  of  its  germ  or  toxin,  it 
is  logical  to  avoid  the  locality,  condition,  food  or  water  by  which 
such  germ  or  toxin  has  presumably  entered  the  system,  together 
with  every  unhygienic  condition,  which  may  have  reduced  the  re- 
sistance of  the  S3rstem  and  laid  it  open  to  the  attack.  The  animals 
should  be  removed  to  a  dean,  airy,  building  and  the  old  one 
should  be  thoroughly  emptied,  purified  and  whitewashed,  the 
lime-wash  containing  4  ozs.  of  chloride  of  lime,  or  i  dr,  of  mer- 


124  Veterinary  Medicine, 

curie  chloride  to  the  gallon.  Drains  and  gutters  should  have 
special  attention  and  the  animals  should  not  be  returned  until  the 
stable  is  thoroughly  dry.  A  change  of  feed  is  imperative  when 
there  is  any  suggestion  of  damp,  mustiness  or  fermentation,  and 
even  in  the  absence  of  such  indications,  since  the  ferments  and 
their  products  may  still  be  present  in  a  dried  condition.  It  should 
also  be  an  object  to  correct  any  morbid  or  pyogenic  condition  of 
the  pharynx,  Eustachian  pouch,  nose  or  ear,  by  appropriate 
measures  and  the  inhalation  of  sulphurous  acid  or  chlorine  may  be 
resorted  to  with  advantage. 

As  medicinal  treatment,  Large  advises  to  give  at  the  outset  i  oz. 
aloes  with  one  or  two  drs.  of  solid  extract  of  belladonna  and  as  an 
eliminant,  derivative  and  nervous  sedative  there  is  much  to  be 
said  for  it.  In  case  the  difficulty  of  swallowing  should  prove  a 
serious  barrier  a  hjrpodermic  injection  of  Y^  dr.  barium  chloride, 
I  >^  to  2  grs.  eserine,  or  2  grs.  hydrochlorate  of  pilocarpin  to- 
gether with  %  grain  of  atropin,  may  be  employed.  As  a  sub- 
stitute for  atropin,  ergot,  potassium  bromide,  chloral  hydrate, 
chloroform,  or  phenacetin  have  been  tried  in  diflFerent  cases  with 
varjdng  results.  Iodide  of  potassium  has  been  employed  with 
advantage  in  the  advanced  stages  and  in  convalescence,  and  may 
be  usefully  employed  in  the  early  stages  as  a  sedative  to  the  nerv- 
ous system,  a  deobstruant  and  an  eliminant,  if  not  as  a  direct 
antidote,  to  the  toxins. 

Bleeding  is  generally  condemned,  yet  in  acute  cases  where  there 
are  indications  of  active  brain  congestion,  threatening  convulsions 
or  coma  it  may  tend  to  ward  off  a  fatal  result. 

Cold  applications  to  the  head  are  generally  commended.  Bags 
of  ice  or  snow,  irrigation  with  cold  water,  or  cooling  by  running 
water  at  a  low  temperature,  through  a  pipe  coiled  round  the  head 
or  extended  along  the  spine,  will  meet  the  purpose.  Applied  con- 
tinuously this  constringes  the  bloodvessels  within  the  cranium  as 
well  as  on  its  surface,  lessens  the  exudation,  and  controls  the  pain 
and  spasms.  This  may  be  advantageously  associated  with  warm 
fomentations  to  the  feet  and  limbs,  friction,  or  even  the  applica- 
tion of  stimulating  embrocations  to  draw  the  blood  to  these  parts. 
In  the  smaller  animals  even  warm  baths  may  be  resorted  to  as  a 
derivative,  cold  being  meanwhile  applied  to  the  head  and  spine. 
This  not  only  lessens  the  vascular  pressure  within  the  cranium, 


Abscess  of  the  Brain.  1 25 

but  secures  elimination  of  toxic  matters  by  both  skin  and  kidneys. 
Cold  pure  water  should  be  constantly  within  reach. 

A  most  important  thing  in  the  horse  is  to  put  him  in  slings,  if 
he  is  at  all  able  to  stand  with  their  assistance.  In  decubitus  he 
rests  on  his  side,  with  the  head  on  the  ground,  and  lower  than 
the  splanchnic  cavities.  The  result  is  a  gravitation  of  blood  to- 
ward the  head.  In  the  sling,  with  the  head  fairly  raised  the 
gravitation  is  the  other  way  and  the  head  is  depleted.  If  the 
patient  is  too  ill  to  be  maintained  in  the  sling,  he  may  be  packed 
up  with  bundles  of  straw  on  each  side,  so  that  his  breast  may  lie 
on  a  thickly  littered  bed,  and  his  head  may  be  elevated. 

When  convalescence  sets  in  care  must  be  taken  to  nourish  with 
non-stimulating,  easily  digested  foods,  gruels,  soft  mashes,  pulped 
or  finely  sliced  roots.  In  vomiting  animals  rectal  alimentation 
may  become  necessary.  The  rise  of  cranial  temperature  or  the 
aggravation  of  brain  symptoms  should  be  met  as  needed  by  the 
local  application  of  cold,  and  potassium  iodide  and  iron  or  bitter 
tonics  may  be  given  if  they  do  not  interfere  with  digestion. 


ABSCESS  OF  THE  BRAIN. 

Infection,  in  traumas,  meningitis,  encephalitis,  strangles,  etc.  Symp- 
toms :  evidence  of  trauma,  chill,  hyperaesthesia,  irritability,  drowsiness, 
giddiness,  stupor,  spasms,  paresis,  coma,  dilated  pupils,  congested  mucosae, 
vomiting.  Location  indicated  by  muscular  groups  involved.  Treatment : 
As  in  meningitis  :  trephining  in  hopeful  cases. 

The  formation  of  abscess  in  the  cranial  cavity  has  been  re- 
ferred to  in  connection  with  injuries  to  the  cranium  and  meningo- 
encephalitis. It  may  here  be  said  in  general  terms  that  this  ab- 
scess is  a  product  of  infection.  In  the  horse  the  most  common 
cause  is  strangles,  and  especially  such  cases  as  run  a  tardy  or  ir- 
regular cotirse  with  imperfect  softening  and  limited  suppuration 
in  the  submaxillary  or  pharyngeal  region.  It  is  to  be  looked  on 
'as  an  extension  of  the  purulent  infection  so  as  to  cause  a  second- 
ary abscess.  The  same  may  occur  in  case  of  ordinary  abscess  in 
any  distant  organ.  In  the  brain  as  elsewhere  suppuration  may 
result  from  direct  local  injury  as  in  the  case  of  blows  by  clubs, 
or  yokes,  running  against  walls  or  posts,  falls,  the  effects  of  but- 


126  Veterinary  Medicine. 

ting,  injuries  by  bullets  and  otherwise.  In  these  cases,  as 
noticed  under  concussion,  there  may  be  two  points  of  injury 
(and  two  abscesses)  one,  in  the  seat  of  the  injury,  and  one  in 
a  deeper  part  of  the  brain,  at  the  opposite  wall  of  the  cranium, 
Again  abscess  may  result  in  the  brain  from  extension  from  a 
similar  process  going  on  in  the  vicinity.  Thus  otitis  extends 
through  the  middle  and  internal  ear  to  the  brain,  and  its  start- 
ing point  may  have  been  more  distant,  namely,  in  the  Eustachian 
tube,  or  pouch,  or  in  the  pharynx. 

The  symptoms  vary  according  to  the  size  of  the  abscess,  the 
rapidity  of  its  formation  and  the  amount  of  attendant  congestion. 
In  the  common  cases  resulting  from  strangles,  I  have  usually 
found  the  animal  down,  unable  to  rise,  blind,  amaurotic,  with 
dilated  pupils,  congested  mucous  membranes,  and  occasional 
spasmodic  movements  of  the  limbs,  neck  and  head.  The  S3anp- 
toms  may,  however,  vary  through  hyperaesthesia,  irritability, 
drowsiness,  giddiness,  stupor,  local  or  general  paralysis  with  oc- 
casional spasms  or  convulsions.  There  may  be  an  initial  shiver- 
ing, and  a  rise  of  temperature,  yet  as  pressure  on  the  brain  in- 
creases it  may  become  normal  or  subnormal.  In  circumscribed 
abscess  the  symptoms  may  be  much  less  severe,  not  perhaps  ex- 
ceeding irritability,  drowsiness,  and  some  paresis  or  local 
paralysis. 

In  some  such  cases  one  can  trace  the  connection  with  some  pri- 
mary disease,  (traumatic  injuries  to  the  cranium,  abscess  of  the 
diploe  or  sinus,  parasites  in  the  sinus,  otitis,  or  pharjrngeal  dis- 
ease) which  serve  as  an  indication  of  the  true  state  of  things. 
In  others  there  may  be  circumscribed  local  manifestations  (anaes- 
thesia, hyperaesthesia,  hemiplegia,  paralysis  of  special  muscular 
groups,  or  spasms  of  the  same)  which  may  indicate  more  or  less 
accurately  the  exact  seat  of  the  lesion.  When  well  defined,  this 
localization  of  the  resultant  phenomena,  serves  to  distinguish  this 
and  other  local  lesions,  from  meningitis  which  is  apt  to  be  much 
more  general  in  its  diffusion.  In  the  carnivora  and  omnivora 
vomiting  is  a  marked  symptom. 

Treatment  of  brain  abscess  is  usually  hopeless,  yet  the  at- 
tendant inflammation  may  be  met  as  in  other  cases  of  meningitis. 
If  the  seat  of  abscess  can  be  ascertained  surgical  interference  is 
fully  warranted. 


TUBERCULAR  MENINGITIS. 

I^ittle  seen  in  cattle.  Acute  and  chronic  cases.  Miliary  tubercles  in  pia. 
Hydrocephalus.  Progresses  slowly.  Irritability,  hypercesthesia,  photo- 
phobia, congested  conjunctiva,  grinding  teeth,  spasms,  squinting,  dilated 
pupils,  congested  disc,  drowsiness,  stupor,  coma,  palsy. 

Tubercle  of  the  encephalon  has  been  little  noticed  in  the  lower 
animals,  partly  because  it  is  especially  a  disease  of  early  life, 
while  animals  usually  contract  tubercle  later  in  life,  and  partly 
because  subjective  symptoms  are  inappreciable,  and  the  cranium 
is  seldom  opened  in  post  mortem  examinations.  As  the  af- 
fection usually  appears  as  a  secondary  deposit,  the  tubercles  else- 
where go  a  long  way  toward  identifying  the  nature  of  the  disease 
in  the  brain.  It  has  usually  been  found  consecutive  to  pulmon- 
ary tuberculosis. 

In  a  case  reported  by  Fischoeder  as  seen  at  the  Bromberg 
abattoir,  in  a  350  lbs.  calf,  the  animal  had  shown  weakness, 
stupor  and  a  tendency  to  fall  toward  the  right.  The  brain  lesions 
consisted  of  small  foci  of  tubercle  on  the  posterior  pillars  of  the 
fornix  (trigone)  and  adjacent  parts.  The  left  eye  had  on  its 
inner  aspect,  near  the  junction  of  sclerotic  and  cornea,  a  firm  mass 
with  tubercular  centres,  extending  inward  as  far  as  the  retina. 
The  bronchial  mediastinal,  prepectoral,  brachial  and  precural 
glands  were  tuberculous. 

In  a  case  in  a  cow  reported  by  Lesage  there  were  unsteady 
gait,  impaired  vision,  and  great  timidity.  Necropsy  showed  a 
suboccipital  tubercle  extending  into  the  frontal  sinus  and  cranium, 
and  invading  the  brain  near  the  parietal  lobe  for  more  than  an 
inch.     There  were  retro-pharyngeal  and  pleural  tubercles  as  well. 

In  a  case  of  Routledge's,  with  extensive  recent  exudate,  the 
condition  advanced  from  apparent  health  to  extensive  paralysis 
in  three  days,  while  in  a  case  which  the  author  obtained  in 
slaughtering  a  tuberculous  herd  no  special  nervous  symptoms  had 
been  noticed  during  life.  Much  therefore  depends  on  the  rapidity 
as  well  as  the  seat  of  development. 

The  primary  lesions  in  the  brain  are  of  the  nature  of  miliary 
tubercles  in  the  pia  mater  which  becomes  congested,  rough,  gran- 

127 


128  Veterinary  Medicine, 

ular,  and  throws  out  a  free  serous  secretion.     Thus  hydrocepha- 
lus is  a  usual  concomitant  of  the  affection. 

The  disease  is  characterized  by  its  slow  advance  in  keeping 
with  gradual  increase  of  the  tubercle  and  is  thus  distinguishable 
from  the  more  acute  congestions  and  inflammations.  The  earlier 
stages  are  usually  marked  by  nervous  irritability,  hyperaesthesia, 
intolerance  of  light,  closed  eyelids,  congested  conjunctiva,  grind- 
ing of  the  teeth  and  even  spasms  partial  or  general.  The  second 
stage  shows  somnolence,  deepening  into  stupor  or  coma,  or  there 
may  be  going  in  a  circle  or  other  irregular  movement.  Squint- 
ing usually  convergent,  dilated  pupils  and  congestion  of  the  optic 
disc  frequently  occur.  The  sleep,  stupor,  paralysis  or  coma  may 
set  in  early  and  is  usually  largely  due  to  the  amount  of  exudation 
and  the  rapidity  of  its  effusion. 


TUMORS  OF  THE  BRAIN.     NEOPLASMS. 

Bxistence  inferential  with  similar  external  tumors.  Cholesterine  tumors 
on  plexus  of  lateral,  third  or  fourth  ventricle  :  pea  to  egg  :  in  old  ;  con- 
centric layers  with  abundant  exudate.  Symptoms :  slight,  or  excitability, 
dullness,  vertiginous  paroxysms  with  sudden  congestions,  as  in  encepha- 
litis, sopor,  stupor,  paresis,  coma.  Melanoma  :  mainly  meningeal ;  pea  to 
walnut ;  with  skin  melanomata  in  gray  or  white  horses.  Cases.  Pigmented 
sarcomata.  Diagnosis,  inferential.  Psammoma  :  advanced  cholesteatoma, 
melanoma,  fibroma,  etc.:  osteid  tumors.  Nervous  irritation,  delirium, 
spasms,  nervous  disorder,  and  paroxysms.  Myxoma :  contains  mucin  ; 
cells  (in  homogeneous  matrix)  round,  spindle-shaped  or  stellate.  Changes 
to  fat  (cholesterine).  CEdematous  connective  tissue,  neoplasm.  Myxo- 
lipoma.    Myxo-cystoid.     Symptoms. 

Tumors  in  the  brain  are  not  marked  by  distinct  pathognomonic 
symptoms,  so  that  their  presence  is  to  be  inferred  as  a  probability 
rather  than  pronounced  upon  as  a  certainty. 

The  most  common  forms  in  the  horse  are  cholesterine  (choles- 
teatoma), melanotic  (melanoma),  sandy,  gritty,  ( psammoma) » 
and  fibrous  (fibroma). 


CHOLESTEATOMA. 

These  are  tumors  formed  largely  of  the  peculiar  fat  which  is 
found  in  bile  and  brain  matter,  and  that  crystallizes  in  flat  oblong 
scales  with  a  notch  at  one  corner.  The  tumors  are  usually  con- 
nected with  the  choroid  plexus  and  developed  beneath  the  pia 
mater,  and  may  be  of  any  size  from  a  pea  to  a  hen's  egg,  or  in 
exceptional  cases  a  sheep's  kidney.  As  a  basis  there  is  a  stroma 
of  connective  tissue  permeated  by  bloodvessels  from  the  plexus. 
Groups  of  spherical  or  polygonal  cells  fill  the  interstices  while 
fusiform  cells  are  found  in  the  stroma.  There  is  a  variable 
amount  of  phosphate  or  carbonate  of  lime  which  in  oldstanding 
cases  may  give  a  cretaceous  character  to  the  mass.  These  consti- 
tute sandy  tumors  (psammomata). 

Cholesteatomata  are  especially  common  in  old  horses  and  are 
manifestly  connected  with  congestion  of  the  choroid  plexus  and 
exudation.  In  a  recent  case  or  in  a  case  which  has  shown  a  recent 
cerebral  hyperaemia,  we  may  find  a  central  mass  of  yellowish 
cholesterine,  and  surrounding  this  an  abundant  yellow  gelatinoid 
exudation.  This  latter  is  rich  in  cholesterine  which  fails  to  dis- 
solve along  with  the  rest  of  the  exudate  on  the  occurrence  of 
resolution,  and  is  therefore  laid  up  as  the  solid  fatty  material. 
For  the  same  reason  the  fatty  element  is  usually  laid  on  in  layers, 
one  corresponding  to  each  access  of  local  hyperaemia  and  exuda- 
tion. The  great  tendency  to  calcareous  degeneration  has  been 
attributed  to  the  abundance  of  phosphate  of  lime  in  the  cerebral 
exudate. 

The  symptoms  of  these  tumors  are  exceedingly  uncertain. 
Many  such  tumors  of  considerable  size  have  been  found  after 
death  in  animals  in  which  no  disease  of  the  brain  had  been  sus- 
pected during  life.  In  these  it  is  to  be  inferred  that  the  accretions 
were  slow,  gradual,  and  without  any  serious  congestion.  In 
other  cases  the  tumor  is  attended  by  paroxysms  of  vertigo,  or  in- 
dications of  hyperaemia  or  meningitis,  which  will  last  for  several 
days  and  gradually  subside.  It  is  reasonable  to  suppose  that  the 
tumors  are  largely  the  result  of  such  recurrent  attacks  of  en- 
cephalitis, and  are  no  less  the  cause  of  their  recurrence.  The 
9  129 


130  Veterinary  Medicine, 

intervals  of  temporary  recovery  correspond  to  the  subsidence  of 
hyperaemia  and  the  reabsorption  of  the  liquid  portion  of  the 
exudate.  The  manifestations  during  an  access  correspond  directly 
to  those  met  with  in  encephalitis.  As  in  that  affection  there  is 
usually  an  initial  period  of  excitement  and  functional  nervous  dis- 
order tending  to  more  or  less  somnolence,  stupor,  paralysis  or 
coma ,  with  long  intermissions  of  apparently  good  health .  In  other 
cases  the  stupor  or  paretic  symptoms  may  persist  up  to  the  fatal 
issue. 


MELANOMA  OF  THE  ENCEPHAXON. 

Black  pigment  tumors  have  been  found  in  connection  with  the 
brain  and  especially  the  meninges,  var3ring  in  size  from  a  pea  to 
a  walnut,  and  as  a  rule,  secondary  to  similar  formations  else- 
where. They  are  most  common  in  gray  horses  which  have 
turned  white,  and  may  give  rise  to  gradually  advancing  nervous 
disorder.  Bouley  and  Goubaux  record  a  case  of  this  kind  at- 
tended with  general  paralysis.  W.  Williams  reports  the  case  of 
an  aged  gray  stallion  with  melanomata  on  the  meninges  and  in 
the  brain  substance  which  were  associated  with  stringhalt  of  old 
standing.  Mollereau  in  a  vertiginous  horse  found  a  pigmented 
sarcoma  in  the  right  hemisphere  between  the  gray  and  white 
matter,  and  like  an  olive  in  size  and  shape.  There  were  melano- 
mata around  the  anus.  ( Annales  de  Medecine  Veterinaire,  1 889) . 
So  far  as  such  have  been  examined  they  follow  the  usual  rule  in 
melanomata  in  having  a  sarcomatous  structure. 

While  it  is  impossible  to  make  a  certain  diagnosis  without 
opening  the  cranium,  the  condition  may  be  suspected,  in  gray 
horses,  when  melanotic  tumors  are  abundant  in  the  usual  ex- 
ternal situations  (anus,  vulva,  tail,  mammae,  sheath,  lips,  eye- 
lids, etc.),  and  when  brain  symptoms  set  in  and  progress  slowly 
in  such  a  way  as  to  suggest  the  gradual  growth  of  a  tumor. 

Treatment  is  hopeless,  since  if  they  have  invaded  the  brain, 
the  tumors  are  likely  to  be  multiple  in  the  organ,  and  numerous 
and  widely  scattered  elsewhere. 


PSAMMOMATA   (GRITTY  TUMORS)   OF  THE  BRAIN. 

As  already  noted  these  sandy  tumors  are  often  the  advanced 
stage  of  cholesteatomata,  the  abundance  of  the  phosphate  of  lime 
leading  to  its  precipitation  in  the  neoplasm.  The  same  cretaceous 
deposit  often  takes  place  in  old  standing  tumors  of  other  kinds,  as 
in  melanoma,  and  fibroma  so  that  the  sandy  neoplasm  may  be 
looked  upon  as  a  calcareous  degeneration  of  various  forms  of 
intracranial  tumors.  The  same  tendency  to  calcareous  deposit  is 
seen  in  the  tuber  cinereum  (pineal  body)  of  the  healthy  brain 
which  has  taken  its  name  from  the  contained  gpitty  matter.  This 
tendency  to  the  precipitation  of  earthy  salts  may  be  further  recog- 
nized in  the  osteid  tumors  which  occasionally  grow  from  the  dura 
mater. 

The  gritty  tumors  are  especially  found  in  the  older  horses  in 
which  the  tendency  is  greatest  to  extension  of  ossification  and 
calcic  degenerations. 

Like  other  tumors  these  may  attain  a  considerable  size  before 
they  give  rise  to  any  very  appreciable  symptoms,  but  having 
attained  a  given  development — often  the  size  of  a  walnut,  they 
become  the  occasion  of  nervous  irritation,  delirium  and  disorder, 
as  indicated  under  encephalic  hypersemia  and  inflammation, 
cholesteatomata,  etc.  There  may,  however,  be  drowsiness,  stupor, 
coma,  or  paralysis  as  the  exclusive  symptom,  or  there  may  be 
spasms  and  convulsions. 


MYXOMA  OF  THE  BRAIN. 

Myxoma  is  a  tumor  in  which  mucoid  elements  or  a  gelatinoid 
degeneration  and  infiltration  containing  mucin  is  a  prominent 
feature.  The  mucous  tissue  which  constitutes  the  tumor  may  differ 
little  from  ordinary  connective  tissue  except  that  the  intercellular 
spaces  contain  mucin.  Histologically  the  tissue  consists  of  cells 
embedded  in  a  homogeneous  matrix.  The  cells  may  be  of  va- 
rious forms,  round,  in  recent  formations  and  spindle-shaped  or 
star-shaped,  but  especially  the  latter,  in  the  older.  When  incised 
a  fluid  containing  mucus  escapes  in  greater  or  less  abundance. 
131 


132  Veterinary  Medicine, 

While  this  has  properties  resembling  albumen  it  is  distinguished 
by  the  fact  that  the  precipitate  thrown  down  in  it  by  alcohol  is 
softened  and  redissolved  on  the  addition  of  water.  The  precipi- 
tate thrown  down  in  an  albuminous  liquid  is  insoluble  in  water. 

The  formation  of  this  mucous  exudate  is  liable  to  be  followed 
by  fat  so  that  Virchow  considered  it  as  antecedent  to  fat  forma- 
tion. This  is  especially  noticeable  in  the  early  stages  of  the 
cholesteatomata  of  the  choroid  plexus  of  the  horse,  in  which,  as 
observed  by  Fiirstenberg,  Lassaigne,  and  Verheyen,  the  new  for- 
mation is  at  first  a  myxoma,  which  later  becomes  filled  up  with 
cholesterine. 

Recent  observations  tend  to  discredit  the  alleged  distinctive 
character  of  myxoma.  The  meshes  of  all  connective  tissue  con- 
tain a  perceptible  amount  of  mucin.  CBdematous  subcutaneous 
connective  tissue  contains  this  mucin  in  greater  proportion  and 
approximates  to  the  condition  of  mucous  tissue.  The  umbilical 
cord,  which  has  been  long  advanced  as  the  physiological  type  of 
mucous  tissue,  has  been  shown  to  consist  of  ordinary  connective 
tissue  with  an  abundance  of  fluid  in  its  meshes. 

Koster  denies  that  the  myxoma  is  a  special  type  of  tumor  and 
holds  that  it  is  only  a  condition  that  may  arise  in  any  tumor 
which  contains  connective  tissue.  In  other  words,  myxoma  is 
only  an  oedematous  condition  of  the  connective  tissue  neoplasm — 
fibroma,  sarcoma,  carcinoma,  etc. — due  to  passive  congestion  or 
other  circulatory  disturbance. 

As  seen  in  the  brain  of  the  horse  the  formation  is  usually  of  the 
nature  of  a  myxo-lipoma,  as  the  final  outcome  is  usually  the 
cholesterine  bearing  mass.  In  other  cases  the  connective  tissue 
spaces  become  further  distended  with  the  viscous,  gelatinoid 
liquid  and  form  veritable  cysts — myxoma-costoides. 

In  tumors  of  this  kind  affecting  the  choroid  plexus  the  chain 
of  symptoms  is  essentially  the  same  as  given  under  cholesteatoma 
and  the  prognosis  is  nearly  equally  grave.  It  need  only  be  said 
that  in  recent  cases  in  which  there  is  as  yet  little  permanent 
tissue,  measures  may  sometimes  be  hopefully  adopted,  to  secure 
the  reabsorption  of  liquid  constituents,  and  even  perchance  to  re- 
move some  obvious  cause  of  passive  congestion  upon  which  the 
effusion  depends. 


ACROMEGALY.      HYPERTROPHY  OF  THE  PITUITARY 

BODY. 

Like  other  portions  of  the  brain  the  pituitary  body  is  subject 
to  degenerations  and  diseases  of  various  kinds.  This  is  particu- 
larly mentioned  here  because  of  the  occasional  association  of  its 
hypertrophy  with  the  trophic  processes  of  different  parts  of  the 
body.  Along  with  an  over-development  of  the  limbs,  and  less 
frequently  of  the  body,  an  enormous  increase  of  the  hypophysis 
has  been  foumd,  and  the  one  condition  has  naturally  been  set 
down  as  the  result  of  the  other.  In  some  such  instances,  of  over- 
growth, however,  some  other  blood  glands,  such  as  the  thyroid 
or  thymus,  have  been  found  to  be  hypertrophied,  so  that  at 
present  it  is  difficult  to  do  more  than  notice  the  association  ob- 
served between  the  two  conditions'. 


CEREBELLAR  DISEASE. 

Cerebellum  and  coordination.  Presmre  on  adjacent  parts  renders  results 
uncertain.  Generic  symptoms,  ataxia,  titnbation.  Marked  83rmptom8  with 
rapid  morbid  progress.    Treatment :  tonic,  hjgienic. 

Whatever  functions  are  exercised  by  the  cerebellum  there  is 
no  doubt  of  its  control  over  muscular  coordination.  It  is  quite 
true  that  disease  of  any  other  part  of  the  brain  causing  effusion, 
exudation  or  intracranial  pressure  will  more  or  less  completely 
arrest  the  functions  of  the  cerebellum  just  as  disease  of  the  cere- 
bellum producing  intracranial  pressure  will  derange  the  functions 
of  other  parts  of  the  encephalon.  The  general  symptoms  pro- 
duced in  this  way  cannot  therefore  be  accepted  as  indicating  the 
precise  localization  of  an  intracranial  disease.  Dullness,  stupor, 
coma,  dilated  pupils,  choked  discs,  optic  neuritis,  and  vomiting, 
are  in  this  sense  generic  symptoms,  which  may  in  the  absence  of 
fever  indicate  dropsy,  exudation,  apoplexy,  tumor,  concussion  or 
other  lesion,  and  with  hyperthermia  may  indicate  encephalitis  or 
meningitis.  But  if  in  the  absence  of  these  symptoms  and  of  aural 
133 


134  Veterinary  Medicine, 

disease  there  should  appear  ataxia,  swaying  unsteady  gait,  and 
staggering,  there  is  a  strong  presumption  of  cerebellar  disease. 
This  may  also  be  manifested  by  the  other  and  generic  symptoms 
already  mentioned  only  the  diagnosis  is  not  then  so  certain. 
Again  cerebellar  disease  may  exist  without  the  ataxia  and  lack  of 
balance,  but  probably  .only  in  cases  in  which  the  progress  is  slow 
and  the  organ  has  had  ample  time  to  accommodate  itself  to  the  as 
yet  comparatively  restricted  lesions.  .The  result  may  be  a  mere 
defect  of  muscular  tone,  or  it  may  extend  to  an  almost  absolute 
loss  of  contractility,  or  it  may  be  of  any  intermediate  grade. 

Treatment,  which  is  eminently  unsatisfactory,  consists  in  im- 
proving the  general  health  and  tone,  by  corroborant  medicines 
and  conditions  of  life,  and  training  the  muscles  by  carefully  grad- 
uated exercise  and  even  electricity. 


BULBAR   PARALYSIS.     DISEASE   OF  THE   MEDULLA 
OBLONGATA. 

Impaired  innervatioii  of  bnlt>ar  nenrea.  Paresis  of  lips,  tongue,  and 
larynx.  Roaring.  Rapid  pulse.  Glycosuria,  albuminuria.  Ptosis.  Twitch- 
ing eyelids.  Dysphagia.  Paralysis.  Treatment,  rest,  cold  to  head,  laxa- 
tives, nerve  stimulants,  tonics,  electricity. 

The  bulb  is  intimately  connected  with  the  origin  of  the  hypo- 
glossal, glosso-pharyngeal,  spinal  accessory,  vagus,  facial,  and  tri- 
facial nerves  and  active  disease  in  the  bulb  is  therefore  likely  to 
entail  impairment  of  the  function  of  several  of  these  nerves.  In 
man  this  is  recognized  in  chronic  progressive  bulbar  paralysis, 
which  almost  always  affects  the  lips,  tongue  and  larynx  advance- 
ing  steadily  though  slowly  to  a  fatal  termination.  In  degenera- 
tive lesions  there  is  modified  voice,  diflBculty  of  swallowing,  rapid 
pulse,  and  laryngeal  paralysis  (especially  of  the  ar3rtenoid 
muscles).  The  implication  of  the  root  of  the  vagus  may  be  in- 
ferred from  the  arrest  of  inhibition  of  the  heart,  and  from  glyco- 
suria or  albuminuria.  Occasionally  the  ocular  and  palpebral 
muscles  are  involved  causing  ptosis,  or  twitching  of  the  muscles. 
When  the  facial  (7th)  nerve  is  implicated,  paralysis  of  one  or  both 
sides  of  the  face  may  be  marked,  including  often  the  ears.  When 


Loco  Poisoning,     Oxytrofns  Lamberti,  135 

the  glosso-pharyngeal,  the  diflBculty  of  swallowing  is  a  prominent 
feature,  and  when  the  spinal  accessory,  spasm  or  paralysis  of  the 
neck.  In  the  worst  cases  death  supervenes  early,  by  reason  of 
interference  with  the  respiratory  and  cardiac  functions. 

The  treatment  of  these  affections  is  usually  very  tmsatisf actory, 
though  in  meat  producing  animals  it  may  sometimes  be  desirable 
to  preserve  them  in  preparation  for  the  butcher.  Rest,  in  hyper- 
aemic  cases,  cold  to  the  head  and  purgatives,  and  in  those  in  which 
fever  is  absent,  small  doses  of  nerve  stimulants  (strychnia)  and 
tonics  (phosphorus,  phosphates,  ammonia-sulphate  of  copper, 
zinc  sulphate,  silver  nitrate)  may  be  tried.  A  course  of  arsenic 
and  carefully  regulated  electrical  stimuli  may  at  times  give  good 
results. 


LOCO  POISONING.     OXYTROPIS  LAMBERTI.     ASTRA- 
GALUS MOLLISSIMUS. 

Astngalns  Hornii :  A.  Lentiginosns :  A.  MoUisiniiu :  Ozytropis  Lam- 
berti :  O.  Mnlttfloris  :  O.  Deflexa :  SophoraSerecia :  Malvaatnun  Cocciiiiaiii : 
Corydalia  Anrea.  In  diy  regiona:  Canae,  a  paycfaosta.  Bmaciation.  Laaii- 
lode.  Impaired  sight.  lUtisions.  Vice.  Refiiaes  other  food.  Contradic- 
tory views.    Bzperimenta  by  Dr.  Day. 

The  term  loco  is  of  Spanish  origin  and  has  come  to  us  through 
the  Spanish  speaking  residents  on  the  cattle  raising  plains  and 
the  Pacific  Coast.  The  word  is  defined  to  mean  fnad,  crazy, 
foolish.  It  has  been  applied  indiscriminately  to  a  disease  in  stock 
manifested  by  these  S3anptoms,  and  to  a  variety  of  leguminous 
plants,  found  growing  on  the  western  lands  and  supposed  to  cause 
the  disease  in  question.  The  plants  complained  of  are  Astragalus 
Hornii,  and  A.  Lentiginosus  (Griesbach)  in  California,  A. 
Mollissimus  (Torrey)  and  Ox3rtropis  Lamberti  (Ptu^hiana)  in 
Colorada  and  New  Mexico.  Other  allied  species,  and  like  these 
fotmd  also  in  the  other  Rocky  Mountain  States,  Sophora  Sereda, 
Ox3rtropis  Multifloris,  O.  Deflexa,  Malvastrum  Coccinum,  and 
Corydalis  Aurea  var.  Occidentalis  have  been  less  confidently 
charged  with  producing  the  disease. 

These  plants  grow  on  poor,  dry,  sandy  or  gravelly  soils,  and 
having  great  power  of  resisting  drouth,  are  often  in  fair  growth 


136  Veterinary  Medicine, 

and  present  an  abundant  mass  of  leaves  when  surrounding 
vegetation  is  withered  up.  Hence,  it  is  alleged,  the  animals  are 
driven  to  use  it  when  nothing  else  is  obtainable  and  once  accus- 
tomed to  it,  the  desire  for  more  becomes  a  veritable  craze  or  neu- 
rosis, and  the  victim  searches  for  it  and  devours  it  to  the  exclu- 
sion of  other  food. 

The  following  quotations  may  serve  to  illustrate  the  effects 
alleged : 

Among  the  symptoms  first  noticed  are  loss  of  flesh,,  general 
lassitude  and  impaired  vision  ;  later  the  animaPs  brain  seems  to 
be  affected ;  it  becomes  vicious  and  unmanageable  and  rapidly 
loses  both  flesh  and  strength.  Frequently  when  approaching 
some  small  object  it  will  leap  into  the  air  as  if  to  clear  a  fence. 
The  patient  also  totters  on  its  limbs  and  appears  as  if  crazy. 
After  becoming  affected  it  may  linger  many  months,  or  a  year, 
but  usually  dies  at  last  from  the  effects  of  the  complaint.  (Dr. 
Vassey.     Report  of  Dept.  of  Ag^culture,  1884). 

**I  think  very  few  if  any  animals  eat  the  loco  at  first  from 
choice  ;  but  as  it  resists  the  drought  until  other  food  is  scarce 
they  are  first  starved  to  it,  and  after  eating  it  a  short  time  appear 
to  prefer  it  to  anything  else.  Cows  are  poisoned  by  it  as  well  as 
horses,  but  it  takes  more  of  it  to  affect  them.  It  is  also  said  to 
poison  sheep.  As  I  have  seen  its  actions  on  the  horse,  the  first 
symptom  apparently  is  hallucination.  When  led  or  ridden  up  to 
some  little  obstruction,  such  as  a  bar  or  rail  lying  in  the  road,  he 
stops  short,  and  if  urged,  leaps  as  though  it  were  four  feet  high. 
Next  he  is  seized  with  fits  of  mania  in  which  he  is  quite  uncon- 
trollable and  sometimes  dangerous.  He  rears,  sometimes  even 
falling  backwards,  runs  or  gives  several  successive  leaps  forward, 
and  generally  falls.  His  eyes  are  rolled  upward  until  only  the 
white  can  be  seen,  which  is  strongly  injected  and  as  he  sees 
nothing,  is  as  apt  to  leap  against  a  wall  or  a  man,  as  in  any  other 
direction.  Anything  which  excites  him  appears  to  induce  the 
fits,  which,  I  think,  are  more  apt  to  occur  in  crossing  water  than 
elsewhere,  and  the  animal  sometimes  falls  so  exhausted  as  to 
drown  in  water  not  over  two  feet  deep.  He  loses  flesh  from  the 
first,  and  sometimes  presents  the  appearance  of  a  walking  skel- 
eton. In  the  next  and  last  stage  he  only  goes  from  the  loco  Jto 
water  and  back,  his  gait  is  feeble  and  uncertain,  his  eyes  are 


Loco  Poisoning,     Oxytropis  Lamierti,  137 

sunken  and  have  a  flat,  glassy  look,  and  his  coat  is  rough  and 
lustreless.  In  general  the  animal  appears  to  perish  from  starva- 
tion and  consequent  excitement  of  the  nervous  system,  but  some- 
times appears  to  suffer  acute  pain,  causing  him  to  expend  his 
strength  in  running  wildly  from  place  to  place,  pausing  and 
rolling,  until  he  falls  and  dies  in  a  few  minutes. "  (  O.  B.  Ormsby , 
Report  Dept.  of  Agriculture,  1874). 

"  Animals  are  not  fond  of  it  at  first,  or  don't  seem  to  be,  but 
after  they  get  accustomed  to  the  taste  they  are  crazy  for  it  and 
will  eat  little  or  nothing  else  when  loco  can  be  had.  There  seems 
to  be  little  or  no  nutrition  in  it  as  the  animal  invariably  loses  flesh 
and  spirit.  Even  after  eating  of  it  they  may  live  for  years,  if 
kept  entirely  out  of  its  reach,  but  if  not,  they  almost  invariably 
eat  of  it  until  they  die."  (Mrs.  T.  S.  Whipple,  San  Luis,  Cal., 
Report  Dept.  of  Agriculture,  1874). 

"Cattle,  after  having  eaten  it,"  Ox3rtropis  Lamberti,  "may 
linger  many  months,  or  for  a  year  or  two,  but  invariably  die  at 
last  from  the  effects  of  it.  The  animal  does  not  lose  flesh  appar- 
ently, but  totters  on  its  limbs  and  becomes  crazy.  The  sight  be- 
comes affected  so  that  the  animal  has  no  knowledge  of  distance, 
but  will  make  an  effort  to  step  over  a  stream  or  an  obstacle  while 
at  a  distance  off,  yet  will  plunge  into  it  or  walk  up  against  it  on 
arriving  at  it."     (Dr.  Moffat,  U.  S.  Army.) 

"  The  term  loco,  simply  meaning  foolish,  is  applied  because  of 
the  peculiar  form  of  dementia  induced  in  the  animals  that  are  in 
the  habit  of  eating  the  plant.  Mliether  the  animals  (horses 
chiefly)  begin  to  eat  the  plant  from  necessity  (which  is  not  likely) 
or  from  choice,  I  am  unable  to  say.  Certain  it  is,  however,  that 
when  once  commenced,  they  continue  it,  passing  through  a  tempo- 
rary intoxication,  to  a  complete  nerv*ous  and  muscular  wreck  in  the 
latter  stages,  when  it  has  developed  into  a  fully  marked  disease, 
which  terminates  in  death  from  starvation  or  inability  to  digest 
more  nourishing  food.  The  animal,  toward  the  last,  becomes 
stupid  or  wild,  or  even  vicious,  or  again  acting  as  though  attacked 
with  blind  staggers.'  (Dr.  Rothrock.  Report  of  Dept.  Agri- 
culture, 1884). 

Dr.  Isaac  Ott,  of  Easton,  Pa.,  gives  the  following  as  the 
physiological  action  of  the  Astragalus  MoUissimus  ;  "  It  decreases 
the  irritability  of  the  motor  nerve,  greatly  affects  the  sensory 


138  Veterinary  Medicine, 

ganglia  of  the  central  nervous  system,  preventing  them  from 
readily  receiving  impressions.  Has  a  spinal  tetanic  action.  It 
kills  mainly  by  arrest  of  the  heart.  Increases  the  callory  secre- 
tion. Has  a  stupefying  action  on  the  brain.  Reduces  the  cardiac 
force  and  frequency.  Temporarily  increases  arterial  tension, 
but  finally  decreases  it.  Greatly  dilates  the  pupil."  (Amer. 
Jour,  of  Pharmacy,  1882. 

In  opposition  to  these  statements  Professor  Sayre,  of  Kansas, 
after  an  extended  observation,  arrived  at  the  conclusion  that  **  it 
is  a  grave  question  whether  loco  weed  is  a  poison  at  all ;  upon 
chemical  examination  no  poisonous  principle  of  any  kind  was  dis- 
covered ;  no  toxic  effect  was  observable  when  administered  to 
frogs,  cats,  dogs,  or  the  human  species,  ....  the  point  cannot 
be  accepted  as  a  settled  one  whether  loco  is  poisonous  to  cattle  or 
not." 

Dr.  G.  C.  Faville  found  in  locoed  sheep  in  Colorado,  bunches  of 
tapeworms  in  the  gall  ducts.  Dr.  Cooper  Curtice,  who  sub- 
sequently studied  the  subject,  found  the  taenia  fimbriata,  and  be- 
lieves that  to  these  the  sjrmptoms  are  exclusively  due.  **  The 
affected  lambs  are  large  headed  with  undersized  bodies  and  hide- 
bound skins.  Their  gait  is  slightly  like  that  of  a  rheumatic. 
They  seem  to  have  diflBculty  in  cropping  the  shorter  grass  ;  they 
also  appear  to  be  more  foolish  than  the  other  sheep,  standing 
of  tener  to  stamp  at  the  sheep  dogs  or  the  herder  than  the  healthier 
ones.  Others  do  not  seem  to  see  as  well,  or  are  so  affected  that 
they  seem  to  appreciate  danger  less.  In  driving  they  are  to  be 
found  at  the  rear  of  the  flock."     (Animal  Parasites  of  Sheep). 

It  is  altogether  probable  that  the  taeniasis  of  sheep  has  been 
mistaken  for  loco,  but  this  can  hardly  account  for  the  remarkable 
symptoms  found  in  other  genera  of  animals,  as  a  concomitant  of 
an  acquired  and  insatiable  fondness  for  these  leguminous  plants. 
The  taenia  fimbriata  has  been  found  in  sheep  and  deer,  but  there 
is  no  record  of  it  as  a  parasite  of  cattle  and  horses. 

Dr.  Sayre' s  failure  to  find  any  poisonous  principle  in  the  plants, 
or  any  toxic  action  on  frogs,  dogs  or  cats,  cannot  be  received  as 
conclusive  in  face  of  the  result  reached  by  others.  Perhaps 
Dr.  Sayre's  specimens  were  not  grown  under  the  proper  condi- 
tions, or  were  not  collected  in  the  proper  season  to  secure  the 
toxic  ingredient. 


Loco  Poisoning.     Oxytropis  Lamberti.  139 

Miss  C.  M.  Watson,  of  Ann  Arbor,  Mich.,  succeeded  in  sepa- 
rating a  small  amount  of  alkaloid  from  the  root  of  Oxytropis 
Lamberti,  but  did  not  apply  the  crucial  test  of  physiological  ex- 
periment. In  the  Report  of  the  Department  of  Agriculture  for 
1879,  are  given  analyses  of  Oxytropis  Laiiiberti,  Astragalus 
MoUissimus  and  Sophora  Speciosa,  in  each  of  which  a  small 
amount  of  alkaloid  was  found. 

In  1888-9,  Dr.  Mary  Gage  Day,  of  Wichita,  Kansas,  made  care- 
ful experiments  on  cats  and  rabbits,  under  the  supervison  of  Dr. 
Vaughan  in  the  Michigan  Laboratory  of  Hygiene.  She  used  a 
decoction  of  roots,  stems  and  leaves  of  plants  gathered  in  Sep- 
tember and  gave  60  to  70  c.  c.  of  this  to  a  half-grown  vigorous  kit- 
ten daily,  along  with  abundance  of  milk  and  other  food.  In  two 
days  the  kitten  became  less  active,  showed  rough  coat,  increased 
desire  for  the  loco,  with  partial  loss  of  appetite  for  other  food, 
diarrhcea  came  on,  and  retching  and  vomiting  occasionally  oc- 
curred. The  expression  became  peculiar  and  characteristic. 
These  symptoms  increased,  and  emaciation  advanced,  and  on  the 
1 8th  day  periods  of  convulsive  excitement  supervened.  These 
were  sometimes  tetanic,  the  head  being  thrown  backward  and  the 
mouth  frothing.  At  other  times  the  kitten  stood  on  its  hind 
limbs  and  struck  the  air  with  its  fore  paws,  then  fell  backward 
and  threw  itself  from  side  to  side.  There  were  short  intervals 
of  quiet,  life  being  indicated  by  breathing  only.  After  36  hours 
of  these  intermittent  convulsions  paraplegia  set  in,  and  the  kitten 
died  in  two  hours.  There  was  no  apparent  loss  of  consciousness 
before  death. 

Post  mortem  examination  revealed  gastric  and  duodenal  ulcers, 
some  of  which  were  nearly  perforating.  The  heart  was  in 
diastole  ;  brain  and  myel  appeared  normal ;  the  entire  body 
anaemic. 

^o2i  vigorous  adult  cat  60  c.c.  to  70  c.c.  of  a  more  concentrated 
solution  were  given  with  other  food.  The  results  were  essentially 
the  same.  By  the  twelfth  day  the  cat  was  wasted  to  a  skeleton 
and  very  weak.  Paralysis  of  the  hind  limbs  came  on  and  the 
cat  died  on  the  thirteenth  day. 

As  a  test  experiment,  two  strong  young  cats  were  confined  in  the 
same  place,  fed  from  the  same  dish,  and  treated  in  every  way  the 
same,  except  that  the  one  was  fed  daily  a  decoction  of  the  loco. 


I40  Veterinary  Medicine. 

The  one  fed  loco  accfuired  the  loco  disease  with  the  symptoms 
described  above  while  the  other,  eating  ordinary  food  only,  re- 
mained healthy. 

Subcutaneous  injections  of  the  concentrated  decoction  thrown 
into  frogs  and  chickens  at  the  Michigan  Laboratory,  of  Hygiene, 
under  direction  of  Dr.  Victor  C.  Vaughan,  caused  nervous  twitch- 
ing and  in  large  doses,  death  in  i  or  2  hours  from  heart  paralysis. 
The  same  symptoms  were  produced  in  frogs  by  injection  of  an 
alcoholic  extract  of  the  residue  left  after  evaporation  to  dryness 
of  the  decoction. 

The  loss  of  appetite,  acquired  liking  for  the  '*  loco-weed,'*  rough 
coat,  emaciation,  peculiar  expression,  rearing,  plunging,  and  a 
staggering  uncertain  gait  are  among  the  S3anptoms  given  in  the 
earliest  published  observation  on  the  loco  disease,  and  agree  with 
the  statements  universally  made  by  ranchmen.  An  ulcerated 
condition  of  the  intestines  was  also  pointed  out  by  Professor 
Sayre  in  a  locoed  cow  upon  which  he  made  a  necropsy  (Dodge 
City  Times,  July,  1887)  :  but  the  diarrhoea  which  was  so  marked 
a  symptom  in  the  cats  experimented  on,  is  not  mentioned  as  a 
characteristic  symptom  in  horses  and  cattle. 

*  *  From  the  close  agreement  of  the  symptoms  in  the  cats  with 
those  universally  recognized  in  locoed  horses  and  cattle,  I  con- 
clude that  the  cases  described  above  were  genuine  cases  of  the 
* 'loco  disease  "  and  are,  so  far  as  can  be  ascertained,  the  first 
that  were  ever  experimentally  produced." 

**  The  craving  for  the  "  loco  "  is  soon  acquired.  The  kittens 
would  beg  for  it  as  an  ordinary  kitten  does  for  milk,  and  when 
sUpplied  would  lie  down  contented.  To  determine  whether  a 
herbivorous  animal  would  easily  acquire  the  **loco  habit*'  a 
young  * '  jack  ' '  rabbit  was  captured  and  fed  a  few  days  on  milk 
and  grass;  then  fresh  **loco'*  was  substituted  for  the  grass. 
At  first  the  **  loco  *'  was  refused,  but  soon  it  was  taken  with  as 
much  relish  as  the  grass  had  been.  After  ten  days  of  the  milk 
and  **loco"  diet  the  rabbit  was  found  dead,  with  the  head 
drawn  back  and  the  stomach  ruptured." 

'  *  With  reference  to  the  character  of  the  plants  at  the  different 
seasons  of  the  year,  I  am  convinced  by  numerous  experiments, 
on  material  gathered  in  different  months,  that  the  greatest 
amount  of  poison  is  present  in  the  autumn  and  winter."     The 


Lead  Poisoning,     Plumhism,  141 

scarcity  of  other  food  at  that  period  of  the  year  is  only  a  partial 
explanation  of  the  number  of  deaths  occuring  at  that  season. 

Conclusions : 

**ist.  There  is  some  poison  in  **loco  weed"  which  may  cause 
the  illness  and,  if  sufficient  quantity  is  taken,  the  death  of  an 
animal." 

''2d.  This  poison  is  contained  in  the  decoction  obtained  from 
the  plants,  and  by  systematically  feeding  it  to  healthy  cats,  cases 
of  "loco"  disease  may  be  produced." 

**3d.  Taste  for  the  green  * 'loco  weed"  may  be  experiment- 
ally produced  in  the  jack  rabbit." 

4th.  From  the  large  quantity  of  the  plant  or  the  decoction 
required  to  produce  the  disease,  the  poison  must  be  weak,  or  if 
strong,  it  must  be  in  very  small  amount. 


LEAD  POISONING.     PLUMBISM. 

Physiological  action  on  nervona  system.  Sources  :  near  smelting  furnaces 
on  vegetation  ;  paints  ;  paint  scrapings  in  manure  and  on  soils  ;  lead  pack- 
ing of  pumps,  engines,  etc. ;  sheet  lead ;  bullet  spray  ;  wall  paper  lead ; 
leaden  water  pipes  or  cisterns  ;  l^ad  acetate  ;  painted  buckets  ;  painted  silo  ; 
lead  compounds  in  arts.  Experiments  on  animals.  Accidental  poisoning  : 
horse,  fever,  gray  nasal  discharge,  salivation,  convulsions,  paralysis, 
dyspnoea.  Cattle,  emaciation,  dyspoena,  palsy,  tonic  spasm  of  flexors  of 
limbs,  swollen  carpus,  death  in  a  few  months.  Young  worst.  Sheep, 
lambs  paretic.  Swine  in  pens  escaped,  those  at  lai^e  suffered.  Post- 
mortem ;  lead  or  lead  compounds  in  stomach,  or  shown  by  analysis,  in 
gastric  contents,  liver,  spleen,  kidney,  etc.  Tests.  Treatment :  hydft>- 
sulphuric  or  sulphuric  acid,  sulphate  of  magnesia  or  soda,  antispadmodics ; 
in  chronic  cases,  potassium  iodide,  bitters. 

The  physiological  action  of  lead  is  exerted  on  the  nervous  sys- 
tem, so  that  lead  poisoning  may  be  appropriately  enough  treated 
of  as  a  disease  of  the  nervous  system. 

Sources,  The  sources  of  lead  as  a  poison  for  animals  are 
extremely  varied.  In  England  in  the  vicinity  of  lead  mines  and 
smelting  furnaces  it  is  deposited  from  the  air  in  a  fine  powder, 
and  consumed  with  the  vegetation.  Herapath  found  that  the  de- 
posit, in  dangerous  amount,  began  half  a  mile  from  the  chimney 
of  the  smelter  and  extended  about  half  a  mile  further. 


142  Veterinary  Medicine, 

A  second  source  is  in  lead  paints  used  about  farms  and  the 
scrapings  of  paint  pots  thrown  out  with  manure  and  spread 
upon  the  fields.  These  lead  combinations  will  last  for  years  in  the 
soil  or  on  the  surface,  being  plowed  under  one  year  and  turned  up^ 
again  the  next  when  the  occasion  of  their  presence  has  been 
completely  forgotten.  In  one  case  I  found  the  red  lead  paint 
marked  by  the  tongues  of  cattle  at  the  back  of  an  abandoned 
cottage  the  fence  around  which  had  been  broken  down.  In 
another  the  scrapings  were  found  in  an  orchard  which  had  been 
near  and  convenient  for  throwing  them  out.  In  the  third  case  a 
paint  can  hung  on  the  branch  of  an  apple  tree,  well  out  of  the 
way  of  the  stock  as  the  owner  fondly  supposed,  showed  in  its 
contents  the  marking  of  the  barbed  tongues  of  the  cattle.  In 
a  fourth  case  a  barrel  of  paint  was  set  under  the  barn  where 
there  was  not  height  enough  to  admit  the  matured  cattle, 
but  it  bore  the  marks  of  licking  by  the  young  stock,  and  they 
alone  died  but  in  such  numbers  that  tjie  owner  concluded 
it  must  be  the  ** Rinderpest." 

The  lead  packing' from  the  joints  of  pumps,  engines  and  other 
machinery,  thrown  away  around  works  and  mines,  is  a  common 
source  of  the  trouble.  I  once  found  large  quantities  in  the  gas- 
tric contents  of  cows  that  had  died  around  a  coal  mine  in 
Ayrshire,  Scotland. 

Sheet  lead— ;tea-chest  lead — is  another  common  source  of  the 
poison.  This  is  thrown  out,  scattered  with  the  manure  on  the  field, 
and  will  resist  the  elements  for  years  but  dissolves  when  taken 
into  the  acid  stomach  of  the  animal. 

The  spray  from  bullets  in  the  vicinity  of  rifle  butts  is  another 
common  cause  of  the  poisoning. 

In  one  instance  I  have  seen  a  cow  poisoned  by  eating  some  lead- 
impregnated  wall  paper  which  had  been  carelessly  left  in  the 
stable. 

Less  frequently  the  poisoning  comes  from  drinking  water  car- 
ried in  leaden  pipes,  or  left  to  stand  in  a  leaden  cistern.  The 
softest  waters — rain,  snow,  distilled  water — are  the  most  liable  to 
this  impregnation.  The  hard  waters  containing  carbonates,  sul- 
phates or  phosphates,  tend  to  be  decomposed,  the  acid  uniting 
with  the  lead  to  form  comparatively  insoluble  carbonates,  sul- 
phates or  phosphates  of  lead,  which  protect  the  subjacent  lead 


Lead  Poisoning,     Mumfnsm,  143 

against  solution.  The  hardness  of  the  water  is  not,  however,  a 
sufficient  safeguard,  as  iron,  solder,  and  other  agents  present  in 
the  lead  as  an  impurity  or  merely  resting  upon  it,  are  sufficient  to 
set  up  a  galvanic  action  resulting  in  solution. 

The  salts  of  lead  may  find  direct  access  to  the  animal,  as  in  the 
case  reported  by  Gamgee  in  which  a  farmer  used  a  barrel  which 
had  contained  acetate  of  lead  for  mixing  the  feed  given  to  his 
stock.  A  somewhat  similar  source  of  poisoning  is  found  in  the 
use  of  buckets  or  silos  which  have  been  painted  inside,  and  scale 
oflF  in  contact  with  hot  water,  etc. 

Bl3rthe  enumerates  the  following  compounds  of  lead  as  employed 
in  the  arts : 

I  St.  Hair  dyes  which  have  a  basis  of  litharge,  acetate  or  car- 
bonate of  lead  in  combination  with  lime  and  other  agents. 

2nd.  White  lead  in  its  various  forms  is  carbonate  of  lead. 

3rd.  Newcastle  white  is  white  lead  made  with  molasses  vinegar. 

4th.  Notingham  white  is  white  lead  made  with  sour  ale. 

5th.  Miniature  Painter's  white  is  lead  sulphate. 

6th.  Pattison  white  is  an  oxychloride  of  lead. 

7th.  Chrome  Yellow  is  impure  chromate  of  lead. 

8th.  Turner's  Yellow,  Casella  Yellow,  Patent  Yellow  is  oxy- 
chloride of  lead. 

9th.  Chrome  Red  is  a  bichromate  of  lead. 

loth.  Red  Lead  is  the  red  oxide  of  lead. 

nth.  Orange  Red  is  an  oxide  obtained  by  calcining  the  car- 
bonate. 

1 2th.  Nitrate  of  Lead  is  much  used  in  calico  printing. 

13th.  Pyrolignite  of  Lead  is  an  impure  acetate  used  in  dyeing. 

14th.  Sulphate  of  Lead  is  a  by  product  in  the  preparation  of 
acetate  of  aluminium  for  dyeing. 

Forms,  Lead  poisoning  occurs  in  acute  and  chronic  forms. 
The  two  forms,  however,  merge  into  each  other  and  are  largely 
convulsive  and  paralytic. 

Experimentally,  Harnack  found  that  2  to  3  mgrms.  in  frogs 
and  40  mgrms.  in  rabbits  caused  increased  intestinal  peristalsis, 
diarrhoea,  and  paralysis  of  the  heart.  Dogs  had  choreic  symp- 
toms. Gusserno  gave  1.2  grm.  to  rabbits  and  dogs  respectively, 
and  produced  emaciation,  shivering  and  paralysis  of  the  hind 
extremities.     Rosenstein  with  0.2  to  0.5  grm.  obtained  in  dogs 


144  Veterinary  Medicine, 

similar  symptoms  with  epileptiform  convulsions,  and  Heubel  had 
symptoms  of  colic  in  a  few  cases. 

Casual  or  Accidental  Poisoning.  Metallic  lead  is  slowly 
dissolved  and  therefore  large  doses  of  this  may  be  taken  in  with- 
out visible  ill  eflFect.  Shot  has  often  been  given  to  relieve  the 
symptoms  of  broken  wind  in  horses,  and  a  dog  at  the  Lyons 
Veterinary  School  took  four  ounces  without  visible  ill  effect. 
When  finely  divided,  however,  as  in  sheet  lead  or  the  spray  of 
bullets  it  presents  a  much  more  extended  surface  to  oxygen  and 
adds,  and  in  the  acid  stomach  of  monogastric  animals,  or  even  in 
the  organic  acids  of  the  rumen  it  is  dissolved  in  quantity  suflBcient 
to  prove  poisonous. 

Symptoms  in  Horses,  Shenton  thus  describes  his  cases. 
"There  was  a  rough,  staring  coat,  a  tucked  up  appearance  of 
the  abdomen,  and  a  slightly  accelerated  pulse ;  in  fact,  symptoms 
of  febrile  excitement  which  usually,  however,  passed  away  in 
about  a  week.  About  this  time  large  quantities  of  gray  colored 
matter  were  discharged  from  the  nostrils,  and  saliva  from  the 
mouth,  but  at  no  times  was  there  any  enlargement  of  the  sub- 
maxillary, lymphatic,  or  salivary  glands.  Nor  was  there  consti- 
pation of  the  bowels,  which  appears  to  be  nearly  always  present 
in  cases  of  lead  poisoning  in  man.  Fits  and  partial  paralysis 
came  on  at  intervals  ;  and  when  the  animals  got  down  they  often 
struggled,  for  a  long  time  ineffectually,  to  get  up  again.  The 
breathing  up  to  this  time  was  pretty  tranquil,  but  now  became  so 
difficult  and  labored  that  the  patient  appeared  in  danger  of  suffo- 
cation. The  pulse  was  in  no  case  above  60  or  70,  and  I  ascribe 
the  difficulty  of  respiration  to  a  paralyzed  state  of  the  respiratory 
apparatus.  The  animals  did  not  live  more  than  two  or  three 
days  after  these  symptoms  appeared.  The  post  mortem  appear- 
ance varied  but  little.  The  lungs  and  trachea  were  inflamed ; 
the  lungs  engorged  with  large  quatities  of  black  blood  ;  the 
trachea  and  bronchia  filled  with  frothy  spume.  In  all  cases  but 
two  the  villous  part-of  the  stomach  presented  isolated  patches  of 
increased  vascular  action,  and  in  all  cases  the  intestines,  and 
especially  the  large  ones,  were  inflamed.  The  blind  pouch  of 
the  caecum  was  nearly  gangrenous.  There  was  nothing  remark- 
able about  the  liver,  spleen  or  kidneys,  except  that  they  were  of 
a  singularly  blue  appearance.* ' 


Lead  Poisoning,     Plumhism,  145 

Symptoms  in  Ruminants.  These  are  described  by  Herapath  as 
following  the  erection  of  lead  smelting  furnaces  in  the  Mendip 
Hills  in  Somersetshire.  There  were  stunted  growth,  emaciation, 
shortness  of  breathing,  paralysis  of  the  extremities,  particularly 
the  hinder  ones,  the  flexor  muscles  of  the  fore  limbs  afifected  so 
that  the  animals  stood  on  their  toes,  swelling  of  the  knees  and 
death  in  a  few  months.  Even  if  removed  to  a  healthy  locality 
the  victims  failed  to  thrive.  The  effects  were  most  pronounced 
in  the  young.  Lambs  were  bom  paralytic ;  at  three  weeks 
old  they  could  not  stand,  and  palsy  of  the  glottis  rendered  it 
dangerous  to  feed  from  a  bottle.  Twenty-one  out  of  twenty- 
three  died  early.  The  milk  of  cows  and  sheep  was  reduced  in 
quiantity  and  quality,  and  contained  traces  of  lead..  The  cheese 
had  less  fat  in  it.  The  dead  showed  the  mucous  surfaces  paler 
than  natural  and  the  lungs  had  large  areas  with  abruptly  circum- 
scribed margins  of  a  dark  red  color,  surcharged  with  fluid.  A 
blue  line  appeared  on  the  gum  close  to  the  teeth,  and  from  this 
a  globule  of  lead  could  be  melted  under  the  blowpipe. 

In  the  cases  that  have  come  under  my  observation  paralysis  of 
the  hind  limbs,  emaciation  and  low  condition,  have  been  most 
prominent  in  the  chronic  forms,  while  these  have  been  compli- 
cated by  torpor  of  the  bowels,  blindness,  stupor,  coma,  and  more 
or  less  frequent  paroxysms  of  delirious  excitement  or  convulsions 
in  the  acute.  In  the  chronic  cases  the  blue  line  on  the  gums  is 
an  important  symptom. 

Herapath  noticed  that  near  the  smelting  furnaces  pigs  escaped 
if  kept  in  the  pen  but  suffered  if  allowed  to  go  at  large.  This  is 
explained  by  the  presence  of  lead  in  the  forms  of  oxide,  car- 
bonate and  sulphate  on  the  herbage,  hay  and  hedge  rows,  and  in 
short  on  all  vegetation. 

In  post  mortem  examination  the  stomach  should  be  carefully 
searched  for  lead  in  the  metallic  form  as  sheet  lead,  bullet  spray, 
etc. ,  for  the  different  forms  of  paint  of  which  lead  forms  an  in- 
gredient, for  the  discarded  white  lead  packing  of  pipes  and  ma- 
chinery, and  even  for  solid  masses  of  metallic  lead.  This  is 
especially  necessary  in  the  case  of  cattle  in  which  the  morbid 
habit  of  eating  non-alimentary  matters  is  so  common,  and  for 
which  the  sweet  taste  of  some  of  the  lead  compounds  seems  to 
offer  an  attraction.  The  lead  being  long  retained  in  the  first 
10 


146  Veterinary  Medicine, 

three  stomachs  in  contact  with  acetic  and  other  organic  acids  is 
especially  liable  to  be  dissolved  and  absorbed  in  dangerous  amount. 
In  the  chronic  cases  especially,  the  test  by  electric  current  may 
furnish  a  valuable  pointer.  In  lead  poisoning  the  muscles  respond 
much  less  actively  to  the  stimulus  than  in  the  normal  condition. 
In  resorting  to  analysis  the  following  table  from  Heubel  of  the 
amount  of  lead  in  the  different  organs  of  a  dog  may  ofiEer  a  guide 
to  the  selection  of  an  organ  for  examination  : 

Liver .0310    .10  per  cent. 

Kidney .0310    .07        ** 

Brain .02  to    .05         ** 

Bones .01  to    .04        ** 

Muscles .004  to  .008        •* 

Professor  George  Wilson  found  the  lead  very  abundant  in  the 
spleen,  and  used  it  for  analysis.  He  dissolved  it  in  aqua  regia 
over  a  slow  fife,  cooled,  filtered,  evaporated,  cleared,  and  boiled 
with  dilute  nitric  acid.  Then  filtered  and  dried  again,  dissolved 
in  dilute  muriatic  acid,  and  finally  applied  the  color  tests.  With 
hydrosulphuric  acid  it  gives  a  black  precipitate,  with  sulphuric 
acid,  a  white,  and  with  potassium  iodide  or  bichromate  a  bright 
yellow.  Or  from  the  solution  of  the  chloride  the  lead  may  be 
obtained  as  a  metallic  deposit  on  zinc  from  which  it  can  be  fused 
into  a  minute  globule  on  charcoal. 

In  the  treatment  of  lead  poisoning  the  first  object  is  to  prevent 
the  further  solution  of  lead  in  the  alimentary  canal  and  to  carry 
it  ofiE.  To  fill  the  first  indication,  hydrosulphuric  acid  or  sul- 
phuric acid  maybe  administered  to  form  respectively  the  insoluble 
sulphide  or  sulphate.  As  a  purgative,  sulphate  of  magnesia  or 
soda  should  be  preferred,  as  favoring  at  once  elimination  and  the 
formation  of  an  insoluble  precipitate.  Large  doses  are  usually 
desirable,  especially  in  ruminants,  because  of  the  bulky  contents 
of  the  stomach  and  the  torpor  of  the  alimentary  canal.  If  grip- 
ping is  a  prominent  symptom  opium  or  other  antispasmodic  must 
be  added. 

In  chronic  cases,  after  the  evacuation  of  the  contents  of  the 
alimentary  canal  small  daily  doses  of  potassium  iodide  will  serve 
to  dissolve  the  lead  out  of  the  tissues,  while  sulphates  may  be 
given  in  small  doses  to  assist  in  elimination  from  the  bowels 
and  to  prevent  reabsorption.  The  treatment  by  potassium  iodide 
is  equally  applicable,  to  assist  in  the  elimination  of  the  lead  that 


Alcoholic  Intoxication,  147 

has  passed  into  the  circulation  and  tissues.  The  doses,  however, 
should  in  any  case  be  small  to  avoid  the  sudden  solution  of  a 
large  amount  of  lead  which  had  been  deposited  in  the  tissues  in  a 
comparatively  insoluble  form.  The  sudden  entrance  into  the  cir- 
culation of  any  large  amount  of  such  lead  would  induce  a  prompt 
return  of  the  toxic  symptoms.  A  continuous  exhibition  of  small 
doses  is  the  course  of  wisdom  and  safety.  The  bowels  should 
meanwhile  be  kept  somewhat  relaxed  by  small  doses  of  sodium 
or  magnesium  sulphate.  As  a  general  tonic  a  course  of  bitters 
may  be  called  for,  especially  when  torpor  or  emaciation  is  pro- 
nounced. 


ALCOHOLIC  INTOXICATION. 

Beer  in  pigs,  alcohol  in  dogs,  abtinthe  in  horse,  alcohol  and  burnt  ales  in 
cows,  alcoholized  grain  in  fowls,  also  fermented  raisins.  Symptoms,  lack 
of  coordination,  staggering,  flashed  mucosae,  full  pulse,  stertor,  sopor,  coma, 
alcoholic  breath,  chill,  muscular  twitching,  delirium.  Treatment :  ammonia 
acetate,  or  cartwnate,  apomorphia,  pilocarpin,  warm  water,  coffee,  stomach 
pump,  electricity. 

Poisoning  by  alcohol  is  less  common  in  the  lower  animals  than 
in  man,  yet  the  veterinary  journals  record  a  considerable  number 
of  cases.  We  have  seen  pigs  suffer  from  drinking  soured  beer  ; 
the  smaller  breeds  of  dogs  (English  terriers)  which  are  systemat- 
ically dwarfed  by  feeding  alcohol  are  often  kept  for  a  length  of 
time  in  a  condition  of  semi-intoxication.  Bissauge  records  the 
case  of  a  horse  inebriated  by  a  glass  of  absinthe  and  a  pint  of 
white  wine,  and  that  of  a  cow  which  died  intoxicated  24  hours 
after  she  had  been  given  three  quarts  of  pure  alcohol  (Rec.  de 
Med.  Vet.  1895).  Dundas  records  intoxication  in  cows  fed  on 
Immt  clUs,  Intoxication  of  barnyard  fowl  and  wild  birds  from 
eating  grain  soaked  in  strong  alcoholic  liquids  has  been  frequent- 
ly noticed,  and  Bissauge  reports  fatal  drunkenness  among  our 
domestic  fowls  from  eating  raisins  and  other  fruits  which  had 
undergone  fermentation. 

The  symptoms  are  too  suggestive  to  require  notice  in  detail. 
There  is  a  lack  of  coordination  of  movement,  a  staggering  gait,  a 
disposition  to  lie,  dilated  pupils,  dark  red  flushing  of  the  visible 
mucous  membranes,  a  full  pulse,  stertorous  respirations,  drowsi- 


148  Veterinary  Medicine, 

ness,  stupor,  and  finally  coma.  The  breath  exhales  the  odor  of 
alcohol,  and  the  temperature  usually  falls,  especially  if  the  subject 
has  been  exposed  to  cold.  It  may  rise  later  in  connection  with 
inflammation  of  the  stomach  or  brain.  Muscular  twitchings  and 
delirium  are  sometimes  found,  and  may  occur  paroxysmally. 

Treatment,  A  pint  of  liquor  of  the  acetate  of  ammonia  to 
horse  or  ox  may  quickly  relieve  the  symptoms,  or  i  oz.  carbon- 
ate of  ammonia  may  be  given  in  solution  in  a  pint  of  vinegar.  If 
more  convenient  the  hypodermic  injection  of  i  or  2  grains  of 
apomorphia,  or  of  5  grains  of  pilocarpin  may  be  employed.  Warm 
water  is  of  the  greatest  value  in  securing  elimination.  A  strong 
infusion  of  coflFee  is  very  effectual.  If  the  patient  is  a  vomiting 
animal  an  emetic  may  be  employed,  and  in  case  of  coma  the 
stomach  pump  may  be  resorted  to.  -  Cold  applied  to  the  head  or 
galvanism  may  be  used  to  rouse  the  patient. 

In  case  of  gastritis  or  encephalitis  following  the  attack  these 
must  be  treated  according  to  indication. 


ANILINE  POISONING. 

Compositioii.  Source.  Uses.  Toxic  action  on  skin,  by  inhalation,  and 
by  stomach.  Symptoms  :  acute,  chronic  Test.  Treatment :  emesis,  pur- 
gatives, stimulants,  tonics,  enemata,  bleeding,  normal  salt  solution. 

Aniline  (Amidobenzene,  Phenylamine,  C,  H,  N)  is  a  product 
of  coal  tar  produced  in  the  manufacture  of  benzole  and  of  aniline 
dyes.  Being  an  object  of  large  production  and  consumption  in 
the  arts,  its  toxic  action  is  seen  not  infrequently  in  man,  and  less 
so  in  animals.  As  used  in  confectionery  it  is  so  diluted  that  it  is 
rarely  or  never  injurious.  On  textile  fabrics,  however,  it  often 
causes  cutaneous  irritation,  and  when  eaten  by  animals  may  be 
toxic.  Workmen  in  the  factories  usually  suffer  from  its  inhala- 
tion. 

TumbuU  gave  Y^,  dram  sulphate  of  aniline  to  a  dog,  inducing 
vomiting  \Vi2y2.  hours  and  purging  one  hour  later.  There  were 
accelerated  pulse,  labored  breathing  and  paraplegia,  followed  by 
recovery  in  five  hours.  Other  objective  symptoms  are  coldness 
of  the  surface,  and  a  bluish  or  purple  color  of  the  visible  mucosae, 


Poisoning  hy  NitfthBemoL  149 

the  blood  failing  to  take  up  oxygen.  In  chronic  aniline  poisoning 
in  man  the  following  symptoms  have  appeared  :  papular,  vesicular 
or  pustular  skin  eruptions,  or  ulcers  on  hands,  feet  and  scrotum  ; 
an  odor  of  coal  tar ;  anorexia,  nausea  and  vomiting ;  headache, 
vertigo,  stupor,  ringing  of  the  ears,  amblyopia,  muscular  spasms, 
muscular  weakness,  anaesthesia  and  motor  paralysis  especially  of 
the  extremities.     The  fatal  dose  is  i  }^  dr.  and  upward. 

Aniline  may  be  extracted  from  the  tissues  by  petroleum  ether, 
and  on  the  evaporation  of  the  solution,  it  is  left  as  an  oily  yellow- 
ish mass  which  gives  the  following  reactions : — with  a  few  drops 
of  sodic  hypochlorite  a  blue  or  violet  blue  ;  with  adds  a  rose  red  ; 
with  bromine  a  flesh  red. 

The  treatment  must  be  by  eUmination  by  emesis,  or  purgation, 
by  removal  from  aniline  fumes  or  mixtures,  and  by  stimulating 
and  tonic  agents.  In  place  of  emesis  a  stomach  tube  and  lukewarm 
water  in  lai^  amount  may  be  employed  to  wash  out  the  stomach. 
For  vomiting  animals  ipecacuan  may  be  employed.  Copious 
enemata  may  be  given,  along  with  purgatives,  to  dear  out  the 
bowels.  As  stimulants  strong  coffee,  caffdn,  camphor,  or  strych- 
nia may  be  employed.  In  case  of  profound  stupor,  prostration,  or 
paresis  it  may  be  desirable  to  reduce  the  amount  of  aniline  in  the 
system  by  free  blood-letting,  care  being  taken  to  inject  subcutem, 
or  into  a  serous  ca\nty,  a  nearly  equivalent  amount  of  normal 
salt  solution. 


POISONING  BY  NITRO-BENZOL. 

Composition.  Source.  Uses.  Chsncten.  Toxic  qualities.  CodthI- 
sions ;  paralysis  ;  cyanosis ;  weak  pulse ;  bitter  almond  odor ;  dark  red 
mine ;  sopor,  giddiness  ;  rednced  size  of  red  blood  globules  ;  congested 
brain,  stomach,  intestines.  Treatment :  emesis,  purgation,  stimulants, 
electricitj,  deriTatiTes.  bleeding,  normal  salt  solution. 

Nitro-benzol  (Nitro-benzine,  C,  H,  NO,  )  is  a  coal  tar  product, 
formed  in  large  quantities  in  the  manufacture  of  aniline  dyes 
and  extensively  used  as  a  flavoring  agents  for  soaps,  sweet  meats, 
etc.  It  is  formed  by  the  addition  of  strong  nitric  acid  to  ben- 
zine, and  appears  as  a  yellow  fluid  with  an  odor  resembling, 
yet  somewhat   different   from,    that   of   prussic  add  or  oil  of 


I50  Veterinary  Medicine, 

bitter  almonds.  It  may  prove  deadly  to  man  or  dog  in  a 
dose  of  fifteen  drops,  though  most  commonly  it  enters  the  system 
by  inhalation.  In  animals  the  prominent  symptoms  are  convul- 
sions and  paralysis,  supervening  on  a  period  of  weak  circulation 
and  pulse,  and  blueness  of  the  visible  mucous  membranes.  The 
characteristic  odor  resembling  the  oil  of  bitter  almonds  exhales 
from  the  lungs  and  skin.  In  man  there  are  dilatation  of  the 
pupils,  blueness  of  the  lips  and  nails,  pallor  of  the  face,  weak 
pulse,  slow  breathing  (often  in  the  end  Cheyne-Stokes  respira- 
tion), a  dark  maroon  or  port  wine  color  of  the  urine,  and  ambly- 
opia. In  the  chronic  cases  the  skin  is  yellowish,  and  there  are 
weariness,  a  dragging  walk,  headache,  morning  anorexia, 
drowsiness,  giddiness,  numbness  of  the  hands  or  other  parts  and 
emaciation.  The  blood  is  chocolate  color  with  red  globules  re- 
duced in  size,  in  number  and  in  haemoglobin,  but  containing  an 
excess  of  carbon  dioxide.  The  brain  is  often  congested  and  the 
gastro-intestinal  mucosa  like  the  skin  may  be  yellow  (from  al- 
leged formation  of  picric  acid).  In  chronic  cases  disseminated 
sclerosis  may  be  seen. 

In  treatment  emesis,  purgation,  stimulants  (ammonia,  cam- 
phor), galvanism,  sinapisms  to  the  chest,  and  phlebotomy,  with 
injection  of  norilial  salt  solution,  may  be  resorted  to,  as  in  aniline 
poisoning. 


POISONING  BY  CARBON  BISULPHIDE. 

Used  to  kill  insects  in  grain,  etc.,  in  bams.  Locally  anaesthetic,  and  irri- 
tant. Inhaled,  toxic,  causing  excitement,  anaesthesia,  collapse.  Large 
doses,  excitement,  reckless  movements,  incoordination,  giddiness,  sleep, 
stertor,  paraplegia.  Small  doses,  weakness,  emaciation,  tremors,  paraplegia, 
polynria,  mellitnria  ;  convulsions,  death.  Distortion  and  varicosity  of  axis 
cylinder,  and  unequal  staining  of  cytoplasm.  Treatment:  pure  air,  good 
diet ;  massage,  electricity,  tonics,  phosphorous. 

This  agent  is  largely  used  in  vulcanizing  and  other  factories 
where  the  employes  are  liable  to  sufifer,  and  also  in  granaries, 
bams,  etc.,  for  the  destruction  of  insects  in  grain  and  other 
objects  and  where  animals  are  liable  to  sufifer. 

Locally  it  acts  like  chloroform,  when  confined  to  the  surface,  as 
under  a  glass  or  covering,  producing  very  active  irritation  with 
anaesthesia. 


Narcotic  Poisons,  151 

/»A/z/f^it  produces  intoxication,  excitement,  general  anaesthesia 
and  finally  collapse.  In  rabbits  it  causes  intense  excitement, 
giddiness,  swaying  from  side  to  side,  and  reckless  leaps  forward, 
followed  by  profound  sleep  with  deep  stertor,  and  paraplegia  for 
half  an  hour  after  the  return  of  consciousness  (Oliver).  When 
taken  for  a  long  time  in  small  quantity  it  caused  weakness, 
emaciation,  tremors,  paraplegia,  and  death  in  convulsions.  There 
was  polyuria,  with  excess  of  sugar  but  neither  urea  nor  albumin. 
The  large  cells  in  the  motor  areas  of  the  brain,  when  stained  by 
Golgi's  method,  showed  the  axis  cylinder  distorted  and  varicose, 
and  the  cytoplasm  stained  unequally.  The  action  on  dogs  was 
essentially  the  same,  and  in  neither  animal  were  changes  in  the 
blood  globules  observed  (Oliver). 

In  man  slow  poisoning  caused  headache  and  exhilerant  intoxi- 
cation, followed  by  depression,  mental  apathy,  dullness,  loss  of 
memory,  impaired  vision,  hearing,  sexual  desire  and  muscular 
power.     Cramps  are  common  (Delpech,  Curtis). 

Treatment  consists  in  giving  pure  air,  good  food,  massage, 
galvanism,  tonics,  and  for  the  persistent  nervous  failure  phos- 
phorus. 


NARCOTIC  POISONS. 

Among  narcotics  and  other  poisons  affecting  the  nervous 
system  may  be  named  the  following  : 

Wild  poppy  which  produces  rabiform  symptoms  or  coma ; 
also  its  alkaloids,  and  especially  opium. 

Buckwheat  when  in  fiour  :  causes  intoxication  like  alcohol. 

Hyoscyamus,  belladonna,  stramonium,  bittersweet,  pro- 
duce weakness,  paresis  and  palsy. 

Cannabis  indica  causes  sluggishness,  vertigo  and  staggering 
in  camivora.  Steeping  of  hemp  in  running  streams  is  forbidden 
in  some  warm  climates.  Even  flax  is  claimed  to  have  caused 
staggering  and  convulsions. 

Skunk  cabbage  (dracontium),  causes  vertigo,  nausea  and 
vomiting. 

Wild  garlic  produces  rabiform  attacks. 

Valerian  leads  to  cerebral  disorder — notorious  in  cats. 

Hellebore  causes  coma,  stupor,  weakness  and  convulsions. 


152  Veterinary  Medicine. 

Veratrum  album,  cevadilla  and  viride  produce  tremors  and 
spasms. 

Ranunculus  causes  stupor,  trembling,  loss  of  lumbar  reflex 
and  sudden  death. 

Digitalis  paralyzes  lips  and  hind  limbs,  with  stupor  and  con- 
tracted pupils. 

CBnanthe  crocata  caused  general  paralysis. 

Conium  maculatum  led  to  anaesthesia,  blindness  dilated 
pupil,  palsy  and  convulsions. 

Vetches,  lupins,  ryegrass,  millet,  etc.,  already  named  (Vol. 
II.  and  Meningitis). 

Fermented  potatoes,  chestnuts,  beechnuts  (see  Vertigo). 

Ergot,  smut,  musty  fodder,  mouldy  meal  or  bread  (see 
poisoning  by  Cryptogams). 

Bitter  almond  cake,  wilted  leaves  of  choke  cherry, 
hydrocyanic  acid  cause  vertigo,  tremors,  paresis,  epileptiform 
convulsions. 

Aconite  leads  to  anaesthesia,  paralysis  and  death. 

Tobacco  entails  nausea,  vertigo,  cardiac  prostration,  and 
death. 

Artemesia  cinac  and  santonin  cause  in  dogs  epileptiform 
convulsions  and  paraplegia. 

Box  leaves  produced  coma,  vertigo  and  convulsions. 

Cicuta  virosa  determines  epileptiform  convulsions. 

Iodoform  entails  stupor,  sopor,  coma,  and  rabiform  s)rmptoms. 

Strychnia,  ergot  and  rhus  cause  tonic  spasms. 

Coriaria  Myrtifolia  of  Southern  Europe  yields  a  deadly 
narcotic  glucoside. 

Fruit  of  the  Umgamu  of  S.  Africa  makes  an  intoxicating 
drink  acting  on  abimals  and  man. 

The  Coca  of  Brazil  paralyzes  sensibility  and  is  said  to  over- 
come fatigue. 

The  Pareca,  a  species  of  inga  of  the  Amazon  valley  acts  in 
the  same  way  :  a  snuff  by  a  new  subject  causing  him  to  fall  as  if 
shot,  while  the  inured  are  exhilarated,  and  hunger,  fatigue  and 
depression  are  relieved.  Captain  Hemdon  says  it  is  made  from 
the  ashes  of  a  vine,  the  seeds  of  the  acacia  angico  and  the  leaves 
of  the  abuta  (cocculus).  When  nearly  dead  with  hunger,  fatigue 
and  fever,  a  snuff  made  him  fall  drunk  in  the  hammock,  his  limbs 
feeling  as  if  under  an  electric  shock  ;  on  rising  he  felt  no  pain  and 


Tetany.  153 

seemed  to  dream,  but  outwalked  the  Indian  guides  for  two  hours 
till  daylight. 

A  dwarf  bush  of  the  mountains  of  Africa  and  a  bulbous  root 
of  Nebraska  are  alleged  to  possess  similar  properties. 

The  hydery — quill — rhay  (Indian  tobacco)  is  used  in  British 
Columbia  and  Alaska  for  the  same  effect  as  opium. 

Sleepy  grass  (Stipa  inebrians  and  S.  Siberica)  of  Texas  and 
New  Mexico  causes  profound  sleep  or  stupor  for  one  or  two  days. 
In  horse  causes  diaphoresis  and  diuresis. 

Tutu  (coriaria  rustifplia)  of  New  Zealand  has  poisonous  seeds, 
acting  even  fatally  on  fatigued  cattle  and  sheep,  but  not  on  horse, 
goat  or  pig.     The  narcosis  lasts  but  a  few  hours. 

Treatment,  Opium  and  some  other  alkaloids  find  an  antidote 
in  potassium  permanganate,  to  be  supplemented  by  diffusible  stimu- 
lants. All  may  be  counteracted  by  eliminants  (vegetable  emetics, 
laxatives  and  diuretics),  seconded  by  abundance  of  water  and 
other  diluents.  When  the  agent  is  acrid  or  irritant  demulcents 
(boiled  flaxseed,  raw  eggs,  milk,  slippery  elm,  albumen,  mallow, 
g^ms,  etc. )  should  be  used  freely,  and  fomentations  and  poultices 
applied  over  the  abdomen  and  loins. 


TETANY. 

Definition.  Casoal  and  experimental  cases  in  animals.  Canses  :  Excision 
of  the  thsTToid,  indigestions  with  fermentation,  rhenmatism,  infection,  ma- 
laria, rachitis,  want  of  hygiene,  hereditary  or  developmental  irritability, 
microbian  poisons.  Symptoms :  intermittent  spasms  with  semi- flexed 
limbs,  tremors.  Diagnosis :  by  the  complete  intermissions  of  spasms,  and 
by  pressure  on  nenre  or  artery,  ronsing  them.  No  fever.  Like  spasms  of 
ergot.  Treatment :  thyroid  extract,  grifting  thyroid ;  remove  sources  of 
irritation,  anti-spasmodics,  warm  or  tepid  baths,  electricity. 

Definition,  Tetany  is  the  name  given  to  a  limited  contraction 
of  a  group  of  muscles  usually  in  the  extremities  occurring 
paroxysmally  with  intervals,  during  which  it  may  usually  be 
rotised  into  activity  by  compression  of  the  nerve  or  artery  pro- 
ceeding to  the  muscles  in  question. 

The  disease  has  not  been  accorded  a  place  in  systematic  works 
on  veterinary  medicine,  though  cases  have  been  recorded  which 
are  supposed  to  have  been  of  this  nature,  and  in  cases  occurring 


154  Veterinary  Medicine. 

in  man  and  associated  with  dyspepsia  and  gastric  dilation, 
Bouveret  and  Devic  have  extracted  from  the  contents  of  the 
stomach  a  toxic  substance  which  caused  tetanic  convulsions  in 
animals.  The  total  removal  of  the  thyroid  gland,  or  even  of 
four-fifths  of  it  (Eiselsberg),  in  the  cat  is  found  to  be  invariably 
followed  by  tetany. 

Causes,  Beside  the  origin  from  the  removal  or  general  disease 
or  degeneration  of  the  thyroid,  it  has  been  attributed  to  digestive 
troubles,  associated  with  fermentations  and  the  production  of 
toxic  matters,  to  rheumatism,  infection  and  malaria,  to  rachitis 
and  unhygienic  conditions.  The  systematic  changes  and  trials  of 
growth  and  development,  of  pregnancy  and  lactation,  seem  to  be 
factors  in  certain  cases.  A  peculiar  irritable  nervous  organiza- 
tion transmitted  by  heredity  is  undoubtedly  a  potent  cause,  and 
upon  this,  bacteridian,  leucocytic  and  other  poisons  operate  so  as 
to  rouse  the  paroxysms. 

Symptoms.  There  are  usually  prodromata  in  the  shape  of  dull- 
ness, prostration,  weariness,  and  some  dullness  of  the  special 
senses.  Fever  is  commonly  absent  and  the  contractions  tend  ta 
affect  both  flexors  and  extensors,  but  as  the  force  of  the  first 
predominates,  the  affected  member  is  usually  held  more  or  less 
rigidly  semi-flexed.  The  spasm  appears  suddenly,  often  taking 
occasion  of  some  voluntary  movement,  and  may  last  for  several 
minutes  or  hours.  It  is  followed  by  an  interval  of  relaxation  of 
equally  uncertain  duration.  Though  usually  attacking  the  limbs 
and  causing  the  victim  to  walk  on  the  toes,  it  may  extend  to  the 
face,  neck  or  trunk,  and  constitute  an  intermittent  trismus, 
oposthotonos  or  emprosthotonos. 

Diagnosis.  Tetany  is  to  be  distinguished  from  tetanus  by  the 
complete  intermissions  of  the  spasms,  and  by  the  voluntary  de- 
velopment of  these  by  compression  of  the  presiding  nerve  or 
artery.  Pressure  on  the  nerve  arouses  its  excitability,  and  com- 
pression of  the  artery  shutting  off  the  supply  of  blood  from  the 
disordered  and  susceptible  muscles,  tends  to  increase  their  irrita- 
bility. Ligature  of  an  artery  supplying  healthy  muscles  causes 
simple  trembling  of  such  organs.  From  the  spasms  of  cerebral 
spinal  or  meningeal  inflammation  tetany  is  distinguished  by  the 
absence  of  fever,  and  the  complete  intermissions  of  the  paroxysms. 
The  spasms  of  ergotism  bear  the  closest  relation  to  those  of  tetany 


Contraction  of  the  Spinal  Cord  in  the  Horse  and  Cow,        155 

and  in  the  absence  of  proof  of  the  ingestion  of  ergot,  might  well 
be  confounded  with  them. 

Treatment.  This  consists  mainly  in  doing  away  with  the  causes, 
when  these  can  be  ascertained.  Portions  of  th>Toid  may  be 
grafted  if  complete  thyroidectomy  has  been  performed,  or  thyroid 
extract  may  be  given.  In  the  human  subject  recoveries  have 
followed  the  expulsion  of  intestinal  worms,  the  cure  of  gastric 
dilation,  dyspepsia,  fermentations,  diarrhoea,  rachitis,  menstrual 
irregularity,  or  auto-intoxication.  Fire  has  seen  recover>'  follow 
the  extraction  of  a  carious  tooth. 

The  spasms  may  be  met  by  the  internal  administration  of  anti- 
spasmodics C chloral,  belladonna,  bromides,  opiates,)  and  the  ex- 
ternal application  over  the  affected  muscles  of  anod>^es  and 
anti-spasmodics  ('belladonna,  opium,  chloroform,  oil  of  cajeput, 
oil  of  peppermint,  menthol,  etc.).  Warm  or  tepid  baths  are 
often  of  great  value  and  a  mild  electric  current  has  been  found 
useful. 


CONGESTION  OF  THE  SPINAL  CORD  IN  THE  HORSE 

AND  COW. 

Under  this  heading  Trasbot  describes  haemoglobinuria  and  par- 
turition paresis,  but  this  tends  to  cover  up  the  more  important 
causes  and  phenomena  of  these  diseases,  which  should  be  kept  in 
the  foreground.  Spinal  congestion  is  undoubtedly  a  feature  of 
both  these  affections,  and  the  sudden  onset  and  rapid  recoveries 
often  seen,  indicate  the  absence  of  inflammator>' action,  yet  this  is 
but  an  accompaniment  of  a  constitutional  morbid  state  which  we 
think  fully  warrants  a  special  consideration  of  each  elsewhere 
(see  Haemoglobinuria  ;  Parturition  paresis;. 

Apart  from  these  affections  congestion  habitually  merges  into 
myelitis  or  spinal  meningitis,  and  may  be  considered  as  the  initial 
stage  of  these  disorders.  It  owns  the  same  causes  and  is  mani- 
fested by  closely  allied  symptoms,  but  these  are  less  persistent, 
and  may  subside  abruptly  into  a  condition  of  health.  The  treat- 
ment will  be  on  the  same  general  lines  as  for  myelitis,  but  with 
much  better  hope  of  success. 


ACUTE  MYELITIS.     POLIOMYELITIS.     INFLAMMA- 
TION OF  THE  SPINAL  CORD. 

Causes :  Stimulating  food  to  excess,  sexual  over- stimulation,  violent  over- 
exertion, hot  sun,  chill,  rheumatism,  traumas,  injury  to  spinal  nerves,  ver- 
tebral caries,  microbian  infection,  narcotics,  vegetable  poisons,  cryptogams. 
Lesions  :  discoloration  of  white  or  gray  matter,  swelling,  friability,  soften- 
ing, extravasations  in  points,  leucocytes  in  excess,  nerve  cells  cloudy,  granu- 
lar, nucleus  enlarged,  stain  highly,  chromophile  granules  irregular,  neuro- 
glia thickened.  Symptoms  :  Hyperthermia,  rigor,  hypersesthesia,  tonic 
contractions  in  neck  and  limbs,  intense  lameness,  paresis,  palsy,  muscular 
atrophy,  areas  of  heat  followed  by  coldness,  such  parts  may  not  perspire, 
palsy  less  complete  than  in  broken  back,  circulation  and  breathing  acceler- 
ated or  slow,  paraplegia  in  large  herbivora.  Diagnosis :  progressive  onset, 
hyperaesthesia  or  rigidity  merging  into  palsy,  retention  and  later  inconti- 
nence of  urine,  extreme  spinal  tenderness,  rapid  atrophy  of  affected  mus- 
cles, skin  sloughing.  Prognosis,  always  grave.  Treatment:  purgation, 
bleeding,  hot  fomentations,  ice  bags,  compresses,  derivatives,  bromides 
chloral,  potassium  iodide,  atropia,  ergot,  electricity,  strychnia,  soft  laxative 
food,  bitters,  phosphates. 

Causes,  Like  congestion  this  may  be  a  result  of  plethora 
in  overfed  animals,  in  those  subjected  to  specially  stimulating 
food  like  gluten  meal,  cotton  seed  meal,  beans,  peas,  vetches  in 
excess,  animal  food  for  herbivora  (the  waste  of  hotels  and  restau- 
rants for  cows,  compressed  meat  products  for  pigs),  a  period  of 
absolute  rest  on  full  rations  in  horses  habituated  to  hard  work 
and  full  feeding ;  of  sexual  over-stimulation  in  males  (stal- 
lion, bull,  ram)  ;  of  violent  over-exertion  especially  if  under 
a  hot  sun  ;  of  sudden  chill  when  over-fatigued  and  perspiring  ; 
of  cold  rain  storms  (Freirier)  ;  of  rheumatism  (Kowalski)  ; 
of  traumatism  (fractures,  sprains,  slipping  with  over-disten- 
sion) ;  of  falls  upon  the  point  of  the  ischium  ;  of  blows  upon 
the  back  (Cruzel,  Trasbot)  ;  of  tumors  implicating  the  cord  ; 
of  too  violent  efforts  in  serving  by  stallions ;  of  injuries  of 
the  great  nerve  trunks  passing  off  from  the  cord  (Gull,  Tras- 
bot, etc. )  ;  of  extensions  from  caries  or  suppurations  of  the 
vertebrae  (Decoste,  Trasbot);  of  microbian  infection,  as  in 
rabies,  distemper,  tubercle,  dourine,  louping  ill,  milk  sickness, 
contagious  pneumonia,  influenza,  and  suppurations  :  of  narcotic 
156 


Acute  Myelitis.     Poliomyelitis,  157 

poisoning,  as  from  ergot,  smut,  the  poisons  of  the  cryptogams 
and  bacteria  of  mouldy  bread,  musty  fodder,  spoiled  meats,  fish, 
etc.  ;  also  the  poisons  of  lolium,  vetch,  lupin,  astragalus, 
oxytropis,  arsenic,  etc. 

Lesions.  These  consist  in  a  yellow  or  pink  discoloration  of 
the  white  and  especially  of  the  gray  matter,  and  a  special  prom- 
inence of  the  puncta  vasculosa  in  the  affected  part.  Swelling  or 
distortion  of  the  part  is  not  usual.  This  may  involve  only  a 
single  gray  horn,  the  two  horns  on  the  same  side,  the  two  in- 
ferior horns,  or  all  four  at  onc6,  or  the  white  matter  adjacent 
may  also  show  the  rosy  tint,  the  large  puncta,  and  a  charac- 
teristic softness  and  friability.  Minute  blood  extravasations  are 
very  significant.  Microscopically  examined  leucocytes  are  found 
in  abundance  in  the  perivascular  spaces  and  in  the  neuroglia. 
The  neurons  (nerve  ganglia  cells)  are  degenerated,  being 
cloudy,  swollen,  with  enlarged  nucleus,  stain  highly,  and  show 
enlargement  of  the  chromophile  granules.  In  a  more  advanced 
stage  the  cell  has  an  indefinite  outline  and  the  nucleus  is  in- 
distinct and  may  fail  to  take  a  stain  ;  the  chromophile  granules 
are  irregular  and  do  not  radiate  evenly  from  a  centre  and  many 
vacuoles  appear.  This  may  lead  to  fatty  softening,  or  to  fibrous 
increase  of  the  neuroglia,  and  sclerosis. 

Symptoms.  These  vary  greatly  in  different  cases  according  to 
the  part  involved,  the  meninges  or  some  special  region  of  the 
cord,  to  the  essential  cause  of  the  inflammation  and  its  acuteness. 
Usually  the  attack  sets  in  slowly  in  contradistinction  to  the 
abrupt  attack  of  congestion.  Hyperthermia  and  rigor  are 
usually  among  the  first  symptoms,  though  in  many  cases  hyper- 
aesthesia  is  the  most  marked  early  symptom.  The  skin  covering 
the  muscles  which  derive  innervation  from  the  affected  section  of 
the  cord  is  the  most  sensitive.  This  is  often  so  extreme  along  the 
vertebral  column  that  percussion  on  the  spinous  processes  or 
pinching  between  the  fingers  and  thumb  causes  the  most  pro- 
nounced wincing  and  dropping  of  the  back.  Copland  and 
Laposso  have  noticed  that  a  sponge  of  hot  water  drawn  along  the 
line  of  the  vertebrae  causes  acute  pain  and  contractions  of  the 
muscles  of  the  back  and  limbs,  which  are  almost  tetanic  in  their 
force.  This  probably  implies  the  existence  of  meningitis,  since 
the  absence  of  rigidity  of  the  muscles  of  the  neck,  back  and 


158  Veterinary  Medicine, 

limbs,  usually  implies  the  absence  of  meningeal  inflammation. 
It  may,  however,  occur  in  localized  or  commencing  myelitis. 
The  existence  of  unilateral  lesions  and  rigidity  determines  intense 
lameness,  which  is  further  characterized  by  the  most  marked 
h3rperaesthesia. 

The  morbid  phenomena  of  the  motor  system  are  more 
characteristically  paretic  or  paralytic  than  spasmodic.  When 
rigidity  or  spasm  ushers  in  the  attack  it  is  superseded  in  a  few 
hours  or  in  two  or  three  days  by  flaccidity  of  the  muscles  of  the 
affected  part,  with  imperfect  control  or  even  complete  paralysis. 
The  muscles  affected  will  depend  on  the  seat  of  the  spinal  lesion. 
If  in  the  neck  it  may  affect  fore  and  hind  limbs,  and  even  the 
chest  and  abdomen  ;  if  in  the  back  or  loins  it  will  induce  para- 
plegia, the  anterior  limit  of  which  will  correspond  to  the  seat  of 
the  lesion  ;  if  near  the  caudal  extremity  of  the  cord,  (lumbar 
portion),  paralysis  of  the  tail  and  of  the  sphincters  ani  and 
vesicae  may  be  prominent  features.  Retention  of  urine  and  faeces 
(spasm)  may  precede  incontinence  (palsy). 

Common  sensation  may  be  dull  or  abolished  on  one  or  on 
both  sides.  If  on  one  side  only,  the  other  may  show  hyper- 
aesthesia. 

Trophic  modifications  are  very  marked  though  they  may 
not  be  noticeable  at  first.  The  paralytic  muscles  waste  rapidly 
and  the  impaired  nutrition  is  manifested  in  the  rapid  formation  of 
sloughing  and  intractable  sores  where  pressure  comes  in  recum- 
bency (the  hips,  stifles,  hocks,  shoulders,  etc.).  This  is 
especially  noticeable  on  parts  supplied  by  the  cord  at  or  behind 
the  seat  of  the  lesions. 

Vaso-motor  changes  are  usually  marked  by  a  preliminary 
hyperthermia  of  the  affected  parts,  followed  by  a  corresponding 
hypothermia.  Sometimes  the  affected  part  of  the  skin  will  re- 
main quite  dry  while  the  rest  of  the  body  is  covered  by  perspira- 
tion. 

Choked  optic  disc  and  retinitis  are  sometimes  present. 

The  febrile  reaction  which  is  at  first  moderate,  gradually  in- 
creases in  force ;  the  animals  become  dull,  drowsy,  careless  of 
food,  and  the  hyperaesthesia  merges  into  paresis  or  paralysis. 
This  is  rarely  so  complete  as  in  fracture  of  the  vertebrae.  If  the 
inflammation  is  restricted  to  the  lower  columns  only,  there  may  be 


Acute  Myelitis.     Poliomyelitis.  159 

akinesis  without  change  of  the  sensitiveness  or  with  hypersensi- 
tiveness.  If  restricted  to  the  upper  columns  there  may  be  sensory 
paralysis  on  the  opposite  side. 

The  heart  sounds  and  pulse  are  usually  altered,  palpitations 
may  appear  early  with  acceleration  and  sharpness  of  the  pulse, 
and  this  may  alternate  with  a  tardy  slow  pulse  with  intermissions. 
Breathing  also  becomes  accelerated  and  in  violent  cases  with 
trembling,  though  in  moderate  inflammation  with  effusion,  soften- 
ing  and  degeneration,  it  is  liable  like  the  heart  beats  to  become 
slow  and  tardy. 

When  vertigo  appears  it  may  be  attributed  to  extension  to  the 
bulb  or  cerebellum,  or  to  the  sympathetic  implication  of  these 
organs. 

The  frequency  with  which  paraplegia  occurs  in  the  larger  her- 
bivora  suggests  a  special  susceptibility  of  the  lumbar  portion  of 
the  cord,  probably  in  connection  with  severe  muscular  effort  of 
the  hind  limbs. 

In  protracted  cases  the  fever  may  run  very  high,  being  compli- 
cated by  septic  poisoning  from  the  numerous  cutaneous  sloughs  and 
sores,  as  well  as  by  cystitis  and  nephritis. 

Diagnosis.  This  may  be  based  on  the  progressive  onset,  unlike 
the  sudden  attack  of  congestion  ;  on  the  occurrence  of  primary 
fever  with  hyperaesthesia  or  even  muscular  rigidity,  merging  into 
a  later  paresis  or  paralysis  ;  on  the  retention  of  urine,  followed  by 
incontinence  ;  on  the  torpor  of  the  rectum  ;  on  the  extreme  ten- 
derness of  the  spine  in  the  region  of  the  inflammatory  lesion  ;  and 
on  the  tendency  to  rapid  atrophy  of  the  affected  muscles,  and  the 
death  and  sloughing  of  the  skin  under  pressure  over  the  promi- 
nent parts  of  the  body.  The  definite  localization  of  the  muscular 
symptoms,  and  the  different  temperature  and  secretion  of  the 
affected  part  of  the  skin,  from  the  unaffected,  are  further  con- 
firmatory of  myelitis. 

Prognosis,  While  always  grave,  myelitis  induced  by  narcotic 
elements  in  the  food  which  can  quickly  be  eliminated  from  the 
system,  and  that  which  has  not  caused  compulsory  decubitus,  or 
persistent  retention  of  urine  and  faeces,  may  be  considered  as 
hopeful.  When,  on  the  other  hand,  the  nature  and  extent  of  the 
lesions  have  entailed  a  prolonged  paralysis,  or  in  the  large  animals, 
(especially  solipeds),  a  persistently  recumbent  position,  there  is 


i6o  Veterifiary  Medicine, 

little  to  be  hoped  for.  The  degenerated  myel,  and  the  badly 
wasted  muscles,  combine  to  prevent  rising  and  the  use  of  the 
limbs,  the  sloughing  bed  sores  quickly  poison  the  blood  and 
general  system,  and  the  animal  sinks  beyond  hope  of  remedy. 
Again,  if  the  faeces  accumulate  in  the  rectum  causing  general  re- 
tention of  the  bowel  contents  and  fermentation,  the  shock  to  the 
nervous  system  and  the  toxins  absorbed  add  materially  to  the 
prostration  and  danger.  Finally  the  retained  urine  infected 
through  the  blood  or  by  a  catheter,  quickly  passes  into  ammoni- 
acal  fermentation,  with  softening  and  detachment  of  the  cystic 
epithelium,  septic  infection  of  the  mucosa,  and  the  extension  of 
this  infection  through  the  ureters  to  the  kidneys.  The  complica- 
tion of  infective  inflammation  of  bladder  and  kidneys  introduces 
one  of  the  most  dangerous  conditions  possible. 

Treatment.  In  an  acute  case,  at  the  outset,  elimination  of  any 
extraneous  poison  should  be  sought  as  the  first  step  toward  a 
restoration  of  the  normal  spinal  functions.  Purgatives  may  be 
employed  to  this  end,  and  if  the  case  is  urgent  and  without  spasms 
immediate  action  may  be  sought  by  a  hypodermic  injection  of 
1)4  gr.  eserine  and  2  grs.  of  pilocarpin.  Meanwhile  the  horse 
may  receive  a  dose  of  aloes,  or  the  cow  one  of  Epsom  salts. 
Abundance  of  watery  or  demulcent  liquids  given  by  the  mouth  or 
as  enemas,  should  not  be  omitted. 

When  plethora  has  been  a  prominent  factor  and  symptoms  are 
urgent,  a  free  bleeding  (4  to  5  quarts  for  horse  or  cow)  from 
the  jugular  vein  may  serve  to  relieve  the  vascular  tension, 
dilute  the  vital  fluid,  and  moderate  the  inflammation.  Hot 
fomentations  or  sinapisms  to  the  limbs,  and  even  cupping  on  the 
neck  and  chest,  may  contribute  to  relieve  the  tension  on  the 
spine.  When  the  temperature  is  already  high,  bags  of  ice  may 
be  applied  to  the  tender  parts  of  the  spine  or  those  indicated  to 
be  the  inflamed  parts  by  the  groups  of  rigid  or  paretic  muscles. 
Wet  compresses  or  evaporating  lotions  may  be  substituted.  In 
the  absence  of  mustard,  tartar  emetic,  biniodide  of  mercury,  or 
euphorbium  may  be  used,  or  even  croton  oil  in  a  carefully 
guarded  manner,  but  cantharides,  oil  of  turpentine,  and  other 
agents  calculated  to  irritate  the  kidneys  are  to  be  avoided. 

Bromides,  hydrobromic  acid,  potassium  iodide,  chloral,  or  bel- 
ladonna may  be  availed  of.     Some  prefer  ergot,  but  this,   like 


AcuU  Myelitis,     PoliomyeliHs.  i6i 

strychnia,  is  of  doubtful  efiFect  or  positively,  injurious  in  most 
cases  in  the  early  stages.  Even  in  the  early  stages  electricity 
may  be  used  in  the  form  of  a  constant  current,  which  tends  to 
vaso-motor  contraction  and  a  better  tone  of  the  capillaries.  The 
electrodes  may  be  applied  along  the  aifected  side  of  the  spine  so 
that  the  current  may  traverse  the  affected  part.  It  may  be  kept 
up  for  ten  to  twenty  minutes  at  a  time  and  repeated  daily.  Any 
undue  suffering  under  the  current  may  be  accepted  as  a  demand 
for  the  reduction  of  its  force  or  its  suspension  for  the  time  being. 

When  the  h3rperthermia  has  subsided  and  the  occurrence  of 
paresis  or  paralysis  demands  nervous  stimuli,  these  may  be  sought 
in  counterirritants,  strychnia,  and  interrupted  currents  of  elec- 
tricity. The  blisters  already  mentioned  may  be  used.  Strychnia 
may  be  used  internally  (horse  or  ox  2  grs.,  sheep  ^  gr.,  dog  ^  to 
tV  gr.)  or  hypodermically  (horse  i>^  gr.,  sheep  }i  gr.,  dog  ^^ 
to  tHr  g^-  )•  Should  this  excite  the  animal  or  aggravate  the  symp- 
toms it  must  be  stopped  and  deferred  until  the  inflammation  shall 
have  more  completely  subsided.  The  same  remark  applies  to 
electricity  which  may  be  tried  in  the  interrupted  current,  and 
graduated  to  the  endurance  of  the  patient  or  entirely  abandoned 
for  the  time. 

If  the  patient  is  able  to  support  itself  on  its  limbs,  it  is  best 
kept  in  a  sling  to  avoid  the  formation  of  sloughs  and  sores.  If 
it  cannot  so  support  itself  a  very  thick  soft  bed  of  litter  is  essen- 
tial to  avoid  the  sloughing  and  septic  poisoning.  Pood  must  be 
laxative  and  easily  digestible  such  as  mashes,  hay  tea,  and  boiled 
or  pulped  roots.  Fresh  green  grass  may  be  employed  when  ob- 
tainable. 

During  convalescence  a  course  of  bitters  with  calcium  phos- 
phate and  carefully  regulated  exercise  are  important.  In  tardy 
cases  Trasbot  especially  recommends  cauterization. 


II 


SPINAL  MENINGITIS. 

Complex  CBBes.  Microbian  invasion.  Lowered  vital  tone.  Traumas. 
Poisons,  parasites,  tubercle,  rheumatism,  neoplasms,  poisonous  food.  Symp- 
toms :  Stiffness,  tonic  contraction,  spasms,  hyperaesthesia  with  warmth, 
enuresis,  paralysis  later.  Treatment :  parallel  to  myelitis  :  cold,  anodynes, 
nerve  sedatives,  and  anti-spasmodics.  saline  purgatives,  diuretics.  Iodine, 
electricity,  cauterization. 

It  is  often  diflScult  to  distinguish  between  spinal  myelitis 
and  meningitis  in  the  lower  animals,  and  the  danger  of  confusion 
is  greater  because  the  two  affections  are  often  conjoined.  Attacks 
appear  to  be  often  associated  with  microbian  invasion  of  the 
membranes,  but  in  its  turn  this  is  often  favored  by  the  lowered 
tone  of  the  membranes  through  mechanical  injury,  circulatory 
disorder,  trophic  changes,  or  the  action  of  poisons  in  the  blood. 
Thus  the  condition  may  supervene  on  fractures,  partial  disloca- 
tions or  sprains  of  the  neck,  back  or  loins,  abscesses  pressing  on 
the  spine,  extension  of  septic  inflammation  from  poll  evil,  fistu- 
lous withers,  or  arthritis  of  the  vertebrae,  penetration  of  the  mem- 
branes by  sharp  pointed  bodies  ( Reindl  found  a  darning  needle 
in  a  cow's  spinal  canal),  invasion  by  microbes  in  influenza,  brust- 
seuche,  dourine,  rabies,  milk  sickness,  distemper,  pyaemia,  sep- 
ticaemia, strangles,  louping  ill,  or  Texas  fever.  The  toxins  of 
tetanus  may  start  similar  trouble.  The  larva  of  cysticercus 
cellulosa  may  cause  meningitis  in  dogs  or  pigs,  the  sclerostoma 
in  the  soliped,  the  filaria  in  dogs  and  strongle  in  a  variety  of 
animals.  Tubercle  of  the  meninges  is  not  unknown,  and  rheu- 
matism is  alleged  as  a  cause.  Neoplasms  commencing  in  the  cord 
act  in  a  similar  way,  and  the  poisons  of  rye  grass,  millet,  loco, 
lupins,  tares  and  vetches  may  act  on  the  membranes  as  well  as 
on  the  myel. 

Symptoms,  In  the  main  these  resemble  those  of  myelitis  and 
are  often  present  at  the  same  time,  and  it  is  only  necessary  to 
note  those  which  are  especially  pathognomonic.  The  early  rigors 
are  followed  by  stiffness  of  the  back  shown  in  rising  or  walking 
and  aggravated  by  motion.  There  may  be  tonic  contraction  of 
the  dorsal  and  lumbar  muscles  amounting  at  times  to  opostho- 
tonos.  The  muscles  of  the  limbs,  chest  or  abdomen  or  some  part 
162 


Acute  Myelitis  in  the  Dog,     Meningo- Myelitis  163 

of  them  may  be  the  seat  of  tonic  or  clonic  spasms.  The  skin  is 
nsnally  hypersensitive  and  this  is  aggravated  by  heat.  The  urine 
is  liable  to  be  retained  because  of  the  pain  of  stretching  to 
micturate.  Paralysis  usually  follows  and  implies  extension  to 
the  myel,  compression  of  the  cord  by  reason  of  exudation,  or 
implication  of  the  spinal  nerves  at  the  points  of  exit.  In  myelitis 
on  the  other  hand  the  spasms  may  be  entirely  absent,  and 
paralysis  sets  in  early  and  extends  rapidly  according  to  the  seat 
and  extent  of  the  lesion. 

Treatment,  This  will  be  along  the  same  lines  as  in  myelitis, 
being  aimed  at  elimination  of  toxic  matters,  and  the  counteract- 
ing  of  the  existing  inflammation.  Anodynes  such  as  bromides 
and  chloral  and  cold  water  or  ice  are  especially  called  for  to  alle- 
viate pain  and  h3rperaesthesia,  and  anti-spasmodics  like  ether, 
chloroform,  chloral,  belladonna,  etc.,  to  allay  the  spasm.  Saline 
purgatives  too,  and  diuretics  may  be  availed  of  to  limit  effusion 
and  favor  reabsorption.  In  the  advanced  stages  iodine  may  be 
freely  applied  to  the  spine,  and  an  occasional  electric  current,  or 
cauterization  may  be  availed  of. 


ACUTE  MYELITIS  IN  THE  DOG.  MENINGO-MYELITIS. 

Causes :  distemper,  in  long-haired  pets,  pysemia,  exposure  to  cold,  vio- 
lent over-exertion,  traumas,  vertebral  caries  or  abscess.  Lesions :  in  lum- 
bar enlaiigement,  horns  yellowish,  red,  friable,  pultaceous,  leucocjrtes  in  ex- 
cess, punctiform  extravasations,  neurons  opaque  ;  granular,  filaments  difflu- 
ent,  varicose,  sclerosis.  Meninges  congested,  thickened.  Symptoms :  as  in 
horse,  extreme  hypersesthesia,  later  anaesthesia,  tremors  or  twitching,  later 
paraplegia.  Treatment :  Laxatives,  ice  bags,  sedatives,  later  derivatives, 
cauterization.  During  convalescence,  phosphates,  iron,  zinc,  strychnia. 
Attend  to  bladder  and  rectum,  light,  laxative  diet,  pure  air  and  water. 

Causes,  This  disease  is  a  common  result  of  distemper  and  ac- 
cording to  Trasbot,  is  much  more  frequent  in  long-haired  and  pet 
dogs  than  in  the  short-haired  and  mongrels.  The  shelter  of  the 
hair,  like  the  warm  indoor  atmosphere,  seems  to  contribute  to  a 
special  sensitiveness  of  the  cutaneous  and  nervous  tissues.  The 
infective  inflammation  of  the  myel  is  also  seen  in  pyaemia,  rabies 
and  milk  sickness.      It  appears  to  be  further  induced  by  ex- 


1 64  Veterinary  Medicine. 

posure  to  cold  draughts  when  heated,  or  excited,  by  plunging 
into  ice  cold  water,  by  lying  on  cold^  damp,  stone  pavement  or 
metallic  plates.  Violent  over-exertion,  excessive  fatigue,  and  a 
variety  of  traumatisms  are  further  factors.  Kicks,  blows  on  the 
back,  concussion  from  falling  from  a  window  or  other  height, 
and  sprains  received  in  fighting  or  otherwise,  are  common  causes. 
Disease  of  the  vertebrae  or  abscesses  in  their  vicinity  will  some- 
times extend  to  the  meninges  and  cord. . 

Lesions.  These  are  like  those  in  the  larger  animals,  being  to  a 
large  extent  determined  by  the  cause  and  nature  of  the  lesion, 
concussion,  sprain^  fracture,  pyaemic,  septicaemic,  or  other  in- 
fection. The  implication  of  the  myel  to  the  exclusion  of  the 
meninges  is  very  frequent  and  the  lumbar  enlargement  is  the 
most  common  seat  of  disease.  I/>calization  in  the  brachial  en- 
largement or  in  one  lateral  half  of  the  cord  is  uncommon.  The 
gray  matter  towards  the  extremity  of  the  horn  is  the  most  com- 
monly involved,  reflecting  a  yellowish,  grayish  red  or  deep  red 
color,  and  breaking  down  into  a  pultaceous  mass  on  the  slightest 
pressure.  At  an  advanced  stage  the  altered  coloring  matter 
gives  to  the  tissue  a  brownish  yellow  color  without  altering  its 
consistency.  The  still  vital  and  vascular  area  around  the  centre 
of  softening  may  be  slightly  swollen  and  abnormally  firm,  The 
neuroglia  is  the  seat  of  leucocytosis,  and  minute  ( usually  puncti- 
form)  extravasations  of  blood.  The  red  globules  are  crenated 
or  otherwise  distorted  and  the  white  are  granular  and  opaque. 
The  neurons  are  swollen,  granular  and  opaque  and  the  nerve 
fibres  are  more  or  less  diffluent,  moniliform  and  in  their  sub- 
stance show  no  clear  outline  of  white  substance  and  axis  cylin- 
der. Interruptions  by  granule  masses  and  vacuoles  are  common. 
In  old  standing  or  chronic  cases  the  liquid  exudate  and  granular 
debris  have  been  largely  absorbed  and  the  thickening  of  the 
neuroglia  by  fibrous  neoplasm,  has  restored  the  firmness  or  even 
approximated  the  part  to  a  condition  of  sclerosis. 

In  case  the  meninges  are  involved  there  is  thickening  by  exud- 
ation into  their  substance  or  on  their  surface,  there  may  be  ad- 
hesion between  the  outer  and  inner  layers  of  the  arachnoid  and  a 
serous  fluid,  red,  milky  or  clear,  distends  the  arachnoid  or  sub- 
arachnoid space.  The  false  membranes,  here  as  elsewhere,  are 
usually  red  if  recent,  and  increase  in  pallor  with  age. 


Acute  Myelitis  in  the  Dog.     Meningo- Myelitis,  165 

Symptoms,  These  are  in  the  main  the  same  as  in  the  larger 
animals.  The  early  excitement  usually  takes  the  form  of  hyper- 
aesthesia.  When  lifted,  pressed,  touched  or  only  approached 
the  dog  may  growl,  howl,  snap,  cringe,  cower  or  tremble,  glancing 
up  meanwhile  with  anxious  or  pleading  eyes.  When  later,  this 
gives  place  to  anaesthesia  no  such  interference  will  draw  a  re- 
spouse.  The  motor  disorders  at  the  outset  are  mostly  of  the 
nature  of  tremors  or  twitching  of  the  muscles  of  the  limbs  or  of 
those  parts  of  the  trunk  corresponding  to  the  seat  of  the  iesion. 
In  exceptional  cases  spasms  or  convulsions  may  be  shown.  Tras- 
bot  records  a  case  of  very  acute  myelitis  of  the  brachial  enlarge- 
ment in  which  there  were  clonic  contractions  of  the  muscles  of 
the  neck,  jaws  and  eyeballs,  and  grinding  of  the  teeth,  which 
condition  lasted  for  thirty  six  hours.  When  this  motor  excite- 
ment merges  into  paralysis  it  usually  attacks  the  hind  limbs  which 
are  extended  backward  helpless  while  the  animal  pulls  himself 
forward  by  his  fore  limbs.  Some  such  cases  are  restless  and  in 
continual  movement  while  others  are  dull,  apathetic  and  indis- 
posed to  move.  The  precise  seat  of  the  paresis  or  paralysis  will 
be  determined  by  the  seat  of  the  lesion  as  in  the  larger  animals. 
Thus  paraplegia  is  most  common,  less  frequently  hemiplegia, 
palsy  of  the  fore  limb,  palsy  of  a  single  limb,  and  monoplegias, 
about  in  the  order  named.  Palsy  of  the  tail  and  sphincters  im- 
plies a  lesion  of  the  lumbar  section  of  the  cord  and  is  very 
offensive  in  the  incontinence  of  urine  and  faeces  especially  in  long- 
haired subjects. 

Treatment,  The  abstraction  of  blood  is  rarely  called  for  in 
myelitis  in  the  dog.  If  admissible  at  all  it  is  in  the  case  of  strong, 
vigorous,  plethoric  animals  which  have  been  attacked  in  connec- 
tion with  sudden  exposure  to  cold  or  accidental  concussion,  and 
which  are  presented  for  treatment  at  once.  Then  leeches  may 
be  applied  to  the  abdomen  or  inside  of  the  thigh,  or  the  jugular 
may  be  opened  with  a  lancet.  •  Usually  on  the  other  hand  the 
patient  is  fat,  lymphatic,  and,  if  a  few  days  have  elapsed,  even 
anaemic,  while  if  he  has  been  the  victim  of  an  accident  the 
shock  and  prostration  would  forbid  any  depressive  measures. 

Derivation  toward  the  bowels  may  be  sought  by  pugative  doses 
of  calomel  or  jalap.  In  case  of  high  fever,  cold  may  be  applied 
(in  the  form  of  icebags,  evaporating  lotions  or  wet  cloths)  to  the 


1 66  Veterinary  Medicine. 

tender  portiou  of  the  spine.  If  the  attack  has  followed  exposure 
to  cold,  salicylate  of  soda  may  be  given,  otherwise  the  bromide  of 
potassium  or  camphor.  Acetanilid  and  other  antithermic  agents 
may  be  used  with  caution. 

With  the  abatement  of  the  high  fever  and  the  supervention  of 
paresis,  if  not  before,  counterirritants  are  demanded. 

Owing  to  the  propensity  to  lick  and  the  danger  of  absorption, 
poisonous  agents  are  virtually  prescribed.  Yet  MoUer  advises 
cantharides,  croton  oil,  mercuric  iodide,  and  oil  of  mustard,  and 
Trasbot  restricts  the  choice  to  tartar  emetic  one  part  to  sixteen 
parts  of  lard.  This  the  latter  rubs  softly  along  the  spine  for  sev- 
eral minutes.  If  the  dog  is  closely  watched  or  muzzled  this  or  the 
mustard  or  croton  oil  may  be  admissible.  If  otherwise,  a  long- 
haired dog  may  be  rubbed  on  the  spine  with  a  combination  in 
equal  parts  of  strong  aqua  ammonia  and  olive  oil ;  or  it  may  have 
applied  for  some  minutes  wet  cloths  rather  hotter  than  the  hands 
can  bear  ;  or  a  light  cauterization  may  be  made  with  a  Paquelin 
cautery.  At  this  stage,  too,  bitters  and  phosphate  of  lime  may 
be  given.  Trasbot  has  long  used  with  the  best  results  i  grain 
doses  of  neutral,  gelatinoid  phosphate  of  lime,  repeated  two  or 
three  times  a  day.  Iron  may  also  be  restored  to,  or  sulphate  of 
zinc.  Strychnia  and  electricity  are  also  of  great  value  as  soon 
as  the  irritability  of  the  spinal  centres  will  allow  of  their  safe  em- 
ployment.    Massage  and  gentle  exercise  are  important. 

From  the  first,  attention  must  be  given  to  obviate  the  retention 
of  urine  and  faeces,  and  the  strict  antisepsis  or  asepsis  of  the 
catheter  adopted  to  prevent  infective  cystitis  and  nephritis. 

Throughout  the  disease  abundant  nourishment  of  an  easily 
digestible  quality  is  demanded.  Cleanliness,  pure  air  and  general 
comfort  must  not  be  forgotton. 


CHRONIC  MYELITIS.     SCLEROSIS. 

Scqncl  to  acnte.  Result  of  sprains  and  spinal  injuries.  Symptoms :  pa- 
resis on  exertion,  lameness  in  one  or  more  limtM,  knuckling,  drcnmdnctive 
movement  of  feet,  uncertain  planting,  dropping,  worse  if  blinded,  phe- 
nomena pmgwim.  Lesions :  sclerosis  of  cord ;  absorption  of  ner¥e  cells 
and  fibres,  in  gray  horns,  and  columns,  superior,  lateral  and  inferior,  cord, 
altered  in  color,  unduly  firm,  in  points  softening.  Stains  deeply  in  CAr- 
mine,  lightly  in  osmic  add  or  hsematozylin.  Meninges  thickened,  nerve 
roots  atrophied.  Diagnosis  :  prerious  acute  myelitis ;  later  muscular  weak- 
ness, and  paresis,  under  exercise :  from  embolism.  Treatment :  hopeless  if 
advanced  ;  progress  delayed  only.  Good  hygiene,  tonics,  open  air,  gentle 
exerdse,  pure  water,  grooming,  succulent  pasture,  nourishing  food,  alka- 
lincs,  common  fait,  phosphates. 

Cases  of  this  kind  have  not  been  satisfactorily  diagnosed,  and 
as  a  mle  domestic  animals  affected  with  partial  paralysis  are 
rarely  allowed  to  live  in  a  condition  in  which  they  are  offensive 
to  themselves  and  owners,  a  source  of  constant  expense  with 
little  or  no  hope  of  recovery  nor  profit.  Again,  in  the  case  of 
the  large  mammals,  the  prolonged  recumbency  and  the  low  grade 
of  nutrition  in  the  semi-paralyzed  parts,  usually  entail  unhealthy 
sores  and  septic  poisoning  which  sooner  or  later  prove  fatal.  It 
is  only,  therefore,  in  the  slighter  cases,  in  which  a  fair  measure 
of  control  over  the  limbs  remains,  that  these  cases  are  likely  to 
survive.  Trasbot  suggests  that  many  cases  which  pass  for  lum- 
bar sprains  are  really  chronic  myelitis  and  on  careful  examination 
will  show  spinal  sclerosis. 

Causes.  These  are  largely  speculative,  yet  doubtless  the  same 
causes  which  determine  the  acute  form,  will  produce  the  chronic 
when  acting  with  less  force  and  greater  persistency .  The  lesions 
that  are  left  after  an  acute  attack  are  calculated  to  keep  up  a 
measure  of  vascular  and  trophic  disorder  which  will  be  found 
associated  with  more  or  less  sclerosis. 

Symptoms.  In  Weber's  case  in  the  horse  (Recueil  de  Med. 
Vet.,  1884,  p.  432)  the  advance  was  slow,  so  that  for  nearly  a 
year  the  manifestations  were  not  diagnostic.  At  first  there  was 
weakness  of  the  hind  limbs  when  worked  to  fatigue.  Perfect 
rest  led  to  improvement,  and  work,  to  aggravation  which  became 
steadily  worse  and  worse.  For  a  length  of  time  the  horse  main- 
167 


1 68  Veterinary  Medicine, 

tained  good  conditiou,  glossy  skin,  elevated  head,  alert  expres- 
sion, keen  sight  and  hearing,  and  normal  breathing  and  pulse. 
Standing  in  the  stall  there  was  no  abnormal  position  of  the  limbs, 
nor  evidence  of  lack  of  perfect  control. 

But  when  moved  all  this  was  changed.  He  showed  first  lame- 
ness in  the  right  fore  limb  and  soon  in  all  four  members.  The 
feet  were  swung  and  planted  uncertainly,  the  animal  swayed  and 
staggered,  the  limb  would  knuckle  over  at  the  knee  or  fetlock, 
or  bend  at  the  hock,  and  be  recovered  with  difficulty.  After 
going  slowly  for  a  few  steps  he  moved  with  greater  freedom 
though  still  with  difficulty,  and  the  trouble  was  greatly  aggra- 
vated when  the  eyes  were  blindfolded.  Then  every  step  threat- 
ened to  precipitate  him  to  the  ground.  The  symptoms  were  es- 
sentially those  of  locomotor  ataxy. 

The  tactile  sensibility  was  unimpaired,  the  loins  had  the 
normal  sensibility,  urination  and  defecation  were  natural  and  the 
appetite  remained  good.  After  ten  months  he  showed  loss  of 
condition,  dullness  of  the  special  senses,  stupor,  and  a  special 
sensitiveness  about  the  head,  and  resented  its  handling. 

Lesions,  Thirteen  months  after  the  commencement  of  the  at- 
tack this  horse  was  destroyed  and  the  cord  was  found  to  be 
profoundly  altered  by  fibroid  degeneration  of  the  neuroglia  and 
absorption  of  the  nerve  elements  (cells  and  fibres),  the  lesions 
afiFecting  different  portions  of  the  gray  horns,  and  the  columns — 
superior,  lateral  and  inferior.  The  affected  portion  of  the  cord 
usually  shows  in  man  a  grayish,  opaque  or  translucent  appear- 
ance, with  in  some  cases  a  shrunken  aspect  and  undue  firmness 
of  texture,  and  at  points,  centres  of  softening.  If  hardened, 
the  sclerosed  sections  take  the  carmine  stain,  deeply,  but  the 
osmic  acid  or  hsematoxylin  stain  very  slightly,  contrary  to  what 
holds  in  health.  In  recent  cases  there  is  only  slight  thickening 
of  the  neuroglia,  but  when  the  disease  is  advanced  the  trabeculae 
are  thick,  dense,  and  firm,  and  the  nerve  fibres  have  largely  dis- 
appeared. The  coats  of  the  blood  vessels  adjacent  to  the  sclerosis 
are  thickened  and  their  lumen  is  narrowed.  Thickening  of  the 
meninges  is  not  uncommon,  either  confined  to  those  covering  the 
diseased  portion  of  the  cord  or  extending  completely  around  it. 
Atrophy  of  the  nerve  roots  is  often  appreciable  by  the  naked  eye. 

Diagnosis.     This  depends  largely  on  the  fact  that  the  condition 


Chronic  Myelitis,     Sclerosis,  169 

follows  an  acute  attack  of  myelitis,  on  the  supervention  of  mus- 
cular weakness  and  lack  of  muscular  control,  whenever  the  animal 
is  exercised  to  fatigue,  the  morbid  s3rmptoms  subsiding  promptly 
when  he  is  allowed  to  rest,  the  aggravation  of  these  symptoms 
when  the  patient  is  blindfolded  and  a  gradual  though  slow  ad- 
vance of  the  s3rmptoms  with  the  lapse  of  time.  From  arteritis 
and  embolism  it  is  to  be  distinguished  by  the  absence  of  the  local 
symptoms  of  pain  and  tenderness,  and  by  the  absence  of  pulsation 
in  the  same  artery  distal  of  the  obstruction  and  of  improvement 
by  the  lapse  of  time  or  a  run  at  grass. 

Treatment  Unless  in  the  very  early  stages  even  a  partial  re- 
covery is  not  to  be  looked  for.  By  a  run  at  grass  or  by  gentle 
well  regulated  exercise  the  impaired  nerves  and  muscles  may  be 
educated  to  a  better  control  for  a  limited  period  but  the  progress 
of  the  disease  is  not  really  arrested  and  the  final  issue  is  likely  to 
be  ruinous.  Even  in  man,  where  90  per  cent,  of  the  cases  are 
connected  with  syphilis,  the  fibroid  h3rperplasia  (sclerosis)  is  not 
remedied  as  gtunmataare,  by  mercury  and  iodides.  In  the  soliped, 
where  no  such  specific  disease  can  be  charged,  the  repair  of  the 
structural  changes  is  no  more  hopeful.  The  many  different 
methods  of  treatment  in  man,— electricity,  blisters,  firing,  stretch- 
ing of  the  spine,  stretching,  of  the  sciatic  and  crural  nerves 
— though  inducing  transient  improvement  in  many*  cases, 
produce  no  real  permanent  benefit,  and  are  to  be  remand- 
ed to  the  region  of  psychic  inferences  which  have  little  or 
no  place  in  the  therapeutics  of  the  lower  animals.  Strych- 
nia, veratrin  and  other  spinal  stimulants  are  of  little  per- 
manent value.  A  general  hygienic  and  corroborative  treatment 
may  be  used  with  the  view  of  retarding  the  progress  of  the  dis- 
ease rather  than  of  curing  it.  Open  air  exercise,  sunshine,  suc- 
culent pasturage,  an  ample  supply  of  pure  water,  and  active 
grooming  are  valuable.  Nourishing  food  is  all  important. 
Lecithin  or  the  hypodermic  injection  of  spermin  or  other  rich 
albuminous  animal  product  is  useful.  A  course  of  bicarbonate  of 
soda  and  carbonate  of  iron  with  or  without  bitters  may  be  tried. 
When  the  animal  must  be  kept  on  dry  winter  food,  he  should 
have  free  access  to  common  salt  and  water.  This  favors  at  once 
absorption,  assimilation,  and  elimination,  and  by  fostering  nu- 
trition and  the  removal  of  waste  matters,  it  contributes  to  keep 


170  Veterinary  Medicine, 

the  disease  in  abeyance.  Phosphoric  acid  and  the  various  phos- 
phates have  been  largely  used  and  largely  rejected,  their  main 
value  being  in  the  tonic  effect  on  the  spinal  centres.  Trasbot 
especially  recommends  the  neutral  gelatinoid  phosphate  of  lime 
as  having  proved  especially  valuable  in  his  hands.  He  gave 
from  I  grain  upward  to  dogs  twice  a  day. 


ARTERITIS  (THROMBOSIS,  EMBOLISM)  OF  THE 
SPINAL  CORD  AND  MEMBRANES. 

Conditions  of  spinal  circulation  favorable  to  embolism  and  microbian  in- 
vasion. Slow  currents.  Blood  stasis.  Free  anastomosis  a  compensation. 
Symptoms.    Treatment. 

Facts  are  wanting  with  regard  to  these  lesions  in  the  domestic 
animals,  but  anatomical,  physiological  and  pathological  consider- 
ation are  strongly  suggestive  of  their  occurrence.  The  vascular 
network  of  the  spinal  cord  favors  a  tardy  circulation,  and  this  in 
turn  is  favorable  to  the  arrest  of  solid  bodies  and  the  delay,  pro- 
liferation and  colonization  of  microbes.  The  median  spinal  artery 
receives  a  supply  of  blood  by  two  trunks,  right  and  left,  entering 
by  the  intervertebral  foramina  at  each  intervertebral  articulation. 
It  has  not,  therefore,  one  continuous,  equable,  onward  flow,  but 
rather  numerous  independent  currents  corresponding  to  the  enter- 
ing vessels,  and  with  intervening  eddies  or  areas  of  comparative 
stagnation.  The  nervous  material  of  the  cord  admits  no  large 
arteries  but  only  capillary  trunks  which  anastomose  freely  in  its 
substance.  This  would  seem  to  entail  a  sluggish  flow,  which 
would  favor  microbian  arrest  and  colonization,  even  if  the  small 
size  of  the  vessels  serves  to  shut  out  clots  of  any  material  size. 
Finally  the  abundant  venous  plexus,  and  especially  the  two  lateral 
venous  sinuses,  communicating  freely  with  each  other  and^ 
through  each  intervertebral  foramen,  with  the  extra  spinal  veins 
determine  a  similar  tardy  flow  that  should  be  favorable  to  morbid 
processes.  If  we  pass  back  of  these  vessels,  we  find  the  posterior 
aorta  to  be  at  once  the  largest  and  the  most  direct  channel  for  the 
entrance  of  emboli  coming  from  the  left  heart  or  limgs.  This 
danger  is  counteracted  in  greater  part  by  the  fact  that  the  greater 


ArteriHs  of  the  Spinal  Cord  and  Membranes.  171 

part  of  this  blood  passes  into  the  large  vessels  which  supply  the 
liver,  spleen,  kidneys,  stomach,  bowels,  and  hind  limbs,  and 
while  embolism  is  well  known  in  these  parts  it  has  not  been 
demonstrated  as  yet  in  the  spinal  cord.  The  toxins  produced  in 
infectious  diseases  and  circulated  in  the  blood  can  often  lead  to 
destruction  of  the  endothelium,  and  inflammation  of  the  deeper 
structures.  In  this  way  any  circulating  microbes  find  a  ready  in- 
fection atrium.  Hektoen  seems  to  have  demonstrated  this  in  the 
case  of  tubercular  meningitis.  By  pressure  of  the  neoplasm  on  the 
vessel  or  by  fibroid  thickening  and  contraction  of  the  walls  of  the 
vessel,  the  subsidiary  cord  is  denied  its  full  supply,  and  degenera- 
tion of  the  nervous  substance  is  invited.  In  the  human  subject 
degeneration  of  the  cord  has  been  shown  to  follow  the  line  of 
such  diseased  arteries.  Thrombosis  follows  in  every  case  in 
which  the  serous  coat  is  involved,  and  embolism  can  easily  occur 
from  clots  small  enough  to  enter  the  capillary  vessels.  I^amy's 
experiment  of  blocking  the  small  arteries  with  inert  powder^ 
shows  that  this  will  give  rise  to  foci  of  hemorrhagic  softening, 
which  commence  in  the  gray  substance.  The  blocking,  how- 
ever, must  be  multiple  to  produce  any  material  eflFect,  as  the  free 
anastomosis  of  the  spinal  capillaries  otherwise  secures  an  abund- 
ant blood  supply  to  adjacent  parts.  In  case  of  an  infective  em- 
bolism the  disease  will  advance  even  if  the  obstruction  is  single. 
The  general  symptoms  of  these  conditions  would  depend  on  the 
exact  seat  of  the  lesion,  and  treatment  would  have  to  proceed  on 
general  principles,  the  object  being  to  check  the  inflammatory 
conditions,  and  trust  to  the  ins  medecatrix  natures  in  connection 
with  rest  and  good  hygienic  conditions. 


HEMORRHAGES  INTO  THE  SPINAI.  MEMBRANES 

Meningeal  Spinal  Apoplexy.    Hi^MATORRACHis.     2.  Hem- 
orrhage INTO  THE  Spinal  Cord.      Spinal  Apoplexy. 

H-flSMATOMYELIA. 

Definition.  Causes :  violent  exertion,  blows,  falls,  morbid  blood,  frac- 
nres,  caries,  tumors,  tubercle,  aneurisms.  Lesions :  Clot  between  or  outside 
membranes  in  meningeal  haemorrhage,  in  gray  matter  and  even  in  white  in 
myelon  bleeding.  Cord  bulges.  If  survives,  nervous  matter  absorbed. 
Symptoms :  Sudden  stiffness  or  palsy  of  given  areas ;  spasms  more  common 
in  meningeal  extravasation.  Rapid  muscular  wasting.  No  fever  at  first. 
Treatment :  cold  to  part ;  slings  ;  atropia,  ergot,  lead  acetate.  Later  as 
for  myelitis.    Large  clot  may  warrant  surgical  interference. 

In  the  first  of  these  forms  the  bleeding  takes  place  between  the 
arachnoid  and  the  two  contiguous  membranes — ^pia  and  dura,  or 
outside  the  dura.  In  the  second  it  takes  place  into  the  substance 
of  the  cord  though  it  may  encroach  on  the  pia  mater.  Both  con- 
ditions have  been  attributed  to  violent  muscular  eflForts  or  con- 
tractions as  in  draught,  racing,  fighting,  leaping,  tetanic  con- 
vulsions, also  to  blows  on  the  back,  or  falls  from  a  height.  Mor- 
bid states  of  the  blood  in  which  there  is  a  hemorrhagic  tendency 
(scurvy,  purpura,  haemophilia,  anthrax)  may  be  contributory 
causes.  Spinal  fractures,  aneurisms,  caries,  tumors  and  tubercle 
may  be  additional  causes. 

Lesions,  In  miningeal  bleeding  the  clot  is  found  outside  the 
dura,  or  between  the  dura  and  arachnoid  which  may  or  may  not 
be  ruptured.  A  clot  on  the  pia  mater  may  press  seriously  on  the 
cord  or  may  cause  rupture  of  the  arachnoid.  In  hemorrhage 
of  the  cord,  the  effusion  usually  begins  in  the  gray  matter,  though 
it  may  extend  far  into  the  white.  It  may  be  circumscribed  to 
half  an  inch  in  diameter  or  affect  almost  the  entire  length  of, 
the  cord.  The  cord  may  be  distinctly  enlarged  at  the  point  of 
effusion,  and  in  exceptional  cases  the  blood  may  have  broken 
through  to  the  membranes.  If  the  patient  survives,  absorption 
and  degenerations  of  the  cord  are  inevitable. 

Symptoms,     In   both   forms   there  is  a  sudden  attack,  with 
172 


spina  Bifida,  173 

stifiFness  or  paralysis  of  given  muscles  and  without  hyperthermia. 
Rigidity  and  spasms  of  the  muscles  are  more  characteristic  of 
meningeal  hemorrhage,  and  early  paralysis  of  the  spinal.  An 
early  hypersesthesia  is  also  most  significant  of  an  efiPusion  in 
the  cord,  Rapid  muscular  atrophy  is  also  characteristic  of 
this.  The  two  conditions  resemble  meningitis  and  myelitis  but 
come  on  much  more  suddenly  and  are  unattended  by  fever. 

Treatment,  Such  cases  are  not  hopeful.  Cold  to  the  a£Fected 
part  of  the  spine,  keeping  the  patient  in  slings  to  solicit  the  good 
e£Fect  of  gravitation,  and  giving  ergot  or  lead  acetate  internally 
are  among  the  first  indications.  Later,  the  treatment  would  be 
practically  the  same  as  for  meningitis  or  myelitis.  In  case  of 
complete  paralysis  from  a  sudden  formation  of  a  large  clot,  it 
has  even  been  advised  to  cut  down  on  the  seat  of  the  injury  and 
evacuate  the  blood,  using  antiseptic  precautions. 


SPINA  BIFIDA. 


This  is  an  elastic  swelling  consisting  of  the  -spinal  meninges 
enclosing  a  liquid,  and  in  some  cases  the  spinal  cord  as  well, 
and  protruding  between  the  unclosed  laminae  of  the  verte- 
bral rings,  usually  in  the  region  of  the  sacrum  or  loins.  It  is 
essentially  an  arrest  of  development  on  the  part  of  the  vertebrae 
and  enveloping  muscles  and  skin,  and  an  extension  of  the  cord 
and  efiPusion  of  the  meningeal  and  central  spinal  liquids,  in  the 
absence  of  their  bony  and  muscular  support.  Hydrocephalus  is 
no  uncommon  complication. 

The  diagnosis  may  be  based  on  the  presence  of  an  elastic,  some- 
what transparent  tumor,  projecting  from  the  vertebral  spines,  at 
birth.. ,  If  it  contains  a  segment  of  the  cord  it  is  usually  flattened, 
depressed  on  the  summit  and  often  associated  with  paralysis. 

As  occurring  in  the  lower  animals  this  need  not  be  treated.  In 
man,  careful  antisepsis  and  evacuation  followed  by  injection  of  a 
solution  of  iodine  10  grs.,  iodide  of  potassium  30  grs.,  and  glyce- 
rine I  oz.,  have,  in  favorable  cases,  secured  obliteration  of  the 
sac,  but  even  then  the  recovery  has  rarely  been  complete  and 
permanent.     Paralysis  and  death  have  usually  supervened. 


X 


SPINAL  CARIES.     TUBERCULAR  OR  OTHER  INFEC- 
TIVE DISEASE  OF  THE  VERTEBRAE. 

Spinal  caries  in  old  horses,  sprains,  fractures,  infections ;  caries  often 
confined  to  articulating  processes :  anatomical  form :  Ozoido-atloid  caries 
from  poll  evil,  concussions,  fights,  rachitis.  Tubercle  of  bone  and  interver- 
tebral  cartilage  in  cattle.  Symptoms  :  distortion,  stiffness,  rigidity  :  stands 
day  and  night,  sensory  and  motor  paralysis:  localization  of  lesion  ;  dyspnoea; 
spastic  palsy  back  of  lesion  ;  effect  on  tail,  sphincters.  Diagnosis  :  progres- 
sive tenderness  and  stiffness  of  spine,  distortion,  localized  exaltation  or  de- 
pression of  nervous  function,  osteoporosis,  rachitis,  caries,  tubercle,  mela^ 
noma,  abscess,  infectious  disease.  Treatment :  Sling  in  narrow  stall,  good 
food,  pure  air,  sunshine,  tonics,  phosphates. 

As  seen  in  the  human  subject  spinal  caries  is  usually  tubercular 
and  is  known  as  ' '  Potfs  disease. '  *  As  seen  in  old  horses  it  appears 
to  be  rather  a  result  of  other  infections,  especially  purulent,  and 
may  have  started  in  connection  with  traumatics  or  mechanical 
injuries  to  the  bones  and  ligaments.  In  such  cases  I  have  seen  it 
repeatedly  in  hollow  backed  horses  in  which  the  line  of  the  spine 
descended  abruptly  and  extremely  from  the  withers  and  rose 
again  to  the  sacrum.  The  distortion  was  so  great  that  the  back 
appeared  as  if  it  could  barely  sustain  the  weight  of  the  animal 
and  yet  the  patients  were  kept  at  work  and  proved  useful  for 
light  driving.  Post  mortem  examination  showed  extensive  caries 
and  suppuration  of  the  vertebral  bodies,  confined,  however,  to  one 
or  two  segments  as  if  due  to  a  mechanical  lesion.  In  the  region 
of  the  loins  it  is  much  more  likely  to  affect  the  articulations  of 
the  vertebral  rings,  because  of  the  manner  in  which  these  are 
wedged  into  each  other  when  the  spine  is  pressed  downward. 
In  the  neck  where  the  normal  movement  is  so  much  freer  such 
injuries  are  much  less  common.  Caries  affecting  the  articular 
surfaces  of  the  axoido — atloid  joint  is  by  no  means  uncommon. 
It  may  follow  poll  evil,  or  injuries  sustained  when  a  horse  runs 
against  a  wall,  or  in  the  fights  of  bulls  or  rams.  Disease  of  the 
vertebrae  may  be  of  the  nature  of  rachitis  occurring  in  this  case 
during  life. 

In  cattle  the  disease  is  liable  to  be  tubercular  in  which  case,  not 
only  is  the  bone  invaded  but  the  morbid  process  extends  to  the 
174 


spinal  Cartes,     InfecHve  Diseases  of  the  Vertehne,        175 

intervertebral  cartilage  and  projecting,  presses  on  the  spinal 
meninges  and  cord.  It  may  even  encircle  the  entire  spinal  cavity 
and  strangle  the  cord.  If  the  pus  should  extend  downward  it 
may  form  abscess  under  the  spine,  and  rupture  into  an  internal 
cavity  or  externally. 

Symptoms.  Injuries  and  disease  of  the  vertebrae  may  last  for  a 
length  of  time  without  implicating  the  spinal  cord  or  nerves. 
They  may  then  cause  only  distortion,  with  stiffness  or  ridigity  of 
the  spinal  column.  When;  however,  the  displacement  of  the  in- 
jured, carious  or  tubercular  bones,  the  distension  of  the  abscess 
or  the  increase  of  the  hyperplasia  leads  to  pressure  on  the 
nerve  roots,  the  meninges  or  cord,  nervous  S3rmptoms  are  like- 
ly to  be  developed.  Compression  of  the  nerve  roots — sensory 
or  motor — ^may  cause  sensory  or  motor  paralysis  or  both, 
limited  to  particular  areas  the  outline  of  which  will  point  to 
the  precise  seat  of  the  lesion.  If  in  the  recti  of  the  head  and 
other  muscles  of  the  neck,  it  points  to  the  anterior  cervical 
vertebrae.  If  in  the  fore  limbs,  it  points  to  the  posterior  bones 
of  the  neck.  The  implication  of  the  diaphragm  would  in- 
criminate the  fourth  and  fifth  cervical  vertebrae.  If  in  the 
crural  muscles  or  those  of  the  quarter  and  thigh,  the  lumbar 
vertebrae  must  be  looked  to.  The  implication  of  the  nerves  of 
the  back,  while  impairing  the  functions  of  the  intercostal  and 
abdominal  muscles,  produce  less  marked  symptoms  than  when 
the  limbs  are  involved. 

When  the  disease  extends  deeper  so  as  to  implicate  the  men- 
inges and  especially  the  cord,  there  is  evidence  of  impairment 
or  interruption  of  conduction  in  the  cord  in  addition  to  the 
simple  involving  of  the  nerves  that  emerge  at  that  point.  Thus 
.serious  disease  or  pressure  on  the  cervical  part  of  the  cord  in 
front  of  the  fourth  vertebra  will  make  respiration  difficult  or 
impossible  and  speedy  asphyxia  may  ensue.  The  paralysis  of 
all  parts  behind  the  lesion  is  overlooked,  in  view  of  the  fatal 
nature  of  the  paralysis  of  the  intercostals  and  diaphragm.  If 
the  interruption  of  conduction  is  incomplete  there  may  be 
spastic  paralysis  and  hyperaesthesia  in  the  limbs  and  trunk  back 
of  the  lesion. 

If  the  dorsal  cord  is  involved  so  as  to  render  conduction  im- 
perfect there  will  be  at  first  imperfect  control  of  parts  posterior  to 


176  Veterinary  Medicine, 

the  lesion,  and  when  still  further  implicated,  flacx:id  or  spastic 
paralysis,  especially  of  the  hind  limbs  and  tail.  When  it  impli- 
cates the  lumbar  region  in  addition  to  the  paralysis  named  for 
the  dorsal,  there  will  be  incontinence  of  urine  and  even  relaxa- 
tion of  the  anal  sphincter.  In  a  case  of  acute  tuberculosis  in  a 
cow,  supervening  on  an  ancient  tuberculous  lesion,  as  seen  by 
the  author,  there  were  imperfect  control  of  the  hind  limbs  and  un- 
certain gait,  with  tenderness  of  the  dorsal  region  as  if  the  animal 
had  sprain  of  the  back. 

Diagnosis  of  these  cases  of  vertebral  disease  may  not  always 
be  possible  in  the  early  stages,  yet  the  symptoms  of  progressive 
tenderness  and  stiffness  in  the  region  of  the  spine,  the  distortion 
in  some  instances  of  the  spinal  column,  the  subsequent  appear- 
ance  of  localized  motor  and  sensory  symptoms,  and  later  still  the 
spasms  or  spastic  paralysis  in  all  parts  behind  the  seat  of  the 
lesion,  will  be  strongly  suggestive  of  such  a  disease.  When  in- 
dications exist  of  osteoporosis,  rachitis,  or  tuberculosis,  of  caries, 
abscess,  or  infectious  lesions  of  the  cervical  or  dorsal  spinal 
region,  the  inference  is  still  stronger.  Then  if  reaction  occurs 
under  the  tuberculin  test,  or  if  the  urine  contains  an  excess  of 
phosphates  in  the  herbivora.  the  case  may  be  diagnosed  with 
certainty. 

Treatment,  This  will  rarely  be  admissible  on  account  of  the 
expense  and  uncertainty  of  result.  Some  meat  animals  may 
be  killed  for  food.  If  otherwise,  keep  in  narrow  stall  where  the 
animal  cannot  turn  even  the  head,  feed  from  moderate  level  to 
avoid  movement  of  the  spine  by  the  upward  and  downward 
movements  of  the  head.  Gentle  brushing  is  useful  as  a  means 
of  cleanliness,  and  of  toning  up  the  muscular  system.  Nourish- 
ing food  of  an  easily  digestible  kind  is  essential,  and  pure  air  and 
sunshine  are  important  auxiliaries.  A  course  of  cod  liver  oil 
with  bitters  may  be  given  to  improve  the  general  health,  cal- 
cium sulphide  may  be  tried  in  case  of  suppurative  caries,  and 
calcium  phosphate  will  usually  be  desirable  to  improve  the  nutri- 
tion and  consistency  of  the  osseous  system.  In  case  of  a  valued 
patient  which  it  is  desirable  to  preserve  for  reasons  of  sentiment 
or  affection,  or  for  breeding  purposes,  one  might  be  warranted  in- 
continuing  a  long  and  expensive  course  of  treatment,  but  in  the 
regular  run  of  cases  considerations  of  humanity  and  economy 
would  counsel  the  prompt  destruction  of  the  animal. 


SLOW  COMPRESSION  OF  SPINAL  CORD.     PARALYSIS. 

Causes  :  Caries,  vertebral  diseases  and  lesions,  neoplasms,  actinomycosis, 
tnbercle,  abscess,  organizing  exndates,  parasites.  Melanoma,  cholesteatoma, 
sarcoma,  papilloma,  lipoma,  f(1ioma,  chrondroma.  Symptoms  :  advance 
insensibly,  or  by  sndden  leap  with  exudate,  spasm,  paresis,  transverse,  senses 
clear,  muscular  atrophy,  advance  from  behind  forward.  Cervical,  dorsal, 
'  lumbar  lesions.  Bladder,  sphincters,  tail.  Symptoms  increased  by  move- 
ment. Treatment :  according  to  le5ion.  Tumors,  hopeless.  Blood  clots. 
Actinomycosis.    Analgesics.    Electricity. 

Causes,  Slowly  progressive  compression  of  the  cord  has  been 
already  noted  as  resulting  from  caries  and  other  diseases  of  the 
vertebrae.  It  remains  to  notice  such  as  result  from  the  growth 
of  tumors  and  other  neoplasms  in  the  spinal  canal.  In  the  horse 
these  are  commonly  melanoma  (in  white  horses),  sarcoma,  en- 
cephaloid,  papilloma,  cholesteatoma,  and  osteoma  ;  in  cattle, 
beside  tubercle  and  actinomycosis,  have  been  found  sarcoma, 
lipoma,  osteoma  and  glioma  ;  and  in  dogs  sarcoma  and  chon- 
dro-sarcoma.  Chronic  abscesses  may  be  met  with  in  all  animals 
determining  the  same  class  of  symptoms  by  slow  pressure.  In 
the  same  manner  exudates  in  process  of  organization  contract, 
and  are  liable  to  compress  the  myelon.  Cadeac  draws  attention 
to  a  calcic  degeneration  of  exudates  in  the  dura  mater  of  the  dog, 
(ossifying  pachymeningitis),  and  of  ossification  of  the  interver- 
tebrae  cartilages  with  vegetations  on  their  surfaces.  Parasites 
also  exercise  a  growing  pressure,  especially  echinococcus,  in  cat- 
tle cysticercus  mediocanellata,  in  sheep  and  dogs  coenurus,  and 
in  pigs  and  dogs  cysticercus  cellulosa. 

Melanoma.  In  gray  and  white  horses,  with  disseminated 
melanosis,  the  spinal  canal  is  often  involved,  the  pigmentary  sar- 
coma appearing  in  small  formations  and  sometimes  large  enough 
to  determine  injurious  pressure.  In  the  early  stages  these  may 
cause  stiffiness  and  lameness  referable  to  particular  muscles  or 
groups,  varying  in  situation,  even  as  to  the  limbs  affected,  at 
successive  dates,  and  finally  merging  into  paraplegia. 

Cholesteatoma  is  less  common  than  in  the  encephalon,  yet 
one  is  reported  by  Drexler  as  attached  to  pia  mater  and  pos- 
sessed of  great  firmness,  crisply  crackling  under  the  knife.  It 
12  177 


178  Veterinary  Medicine, 

doubtless  secures  accretions  under  meningeal  exudates  like  those 
of  the  choroid  plexus. 

Sarcoma  and  encephaloid  are  usually  found  in  connection 
with  the  dura  mater,  and  of  small  size,  but  numerous.  They 
often  surround  the  roots  of  the  spinal  nerves,  and  here  as  on  the 
cord  exert  sufficient  pressure  to  impair  nervous  function. 

Papilloma  has  been  found  connected  with  the  pia  mater  and 
of  marked  vascularity.  The  author  has  found  one  in  the  ewe  in 
a  case  of  the  neurasthenia  of  advanced  gestation. 

Lipoma  is  also  rare.  Osseous  growths  are  common,  being 
favored  by  sprains  and  injuries.  All  show  a  marked  predilection 
for  the  lumbar  and  last  dorsal  vertebrae.  This  may  be  partly  ex- 
plained by  the  liability  to  injury  and  to  disease  invasion  through 
the  interlocking  of  the  joint  surfaces  of  the  rings.  Osteophytes 
growing  from  the  intervertebral  cartilage  are  common  in  the  dor- 
sal region  as  well. 

Glioma  has  been  found  in  cattle,  occupying  the  substance  of 
the  cord  itself  and  growing  to  the  size  of  a  hen's  t%%  or  even  of 
the  closed  fist.  The  cord  is  gradually  atrophied  and  paraplegia  is 
inevitable. 

Chrondro-sarcoma  has  been  found  growing  from  the  inter- 
vertebral fibro  cartilage  of  dogs. 

Tne  Symptoms  may  be  deferred  for  a  length  of  time  on  account 
of  the  accommodation  of  the  myelon  to  the  slowly  increasing 
pressure.  When  they  do  become  manifest,  it  is  usually  at  first  by 
insensible  gradations  so  that  for  a  time  their  existence  is  question- 
able. Yet  a  case  will  sometimes  reach  a  sudden  climax,  by  reason 
of  a  blood  extravasation  or  inflammatory  exudate,  and  the  signs 
of  sudden  pressure  or  acute  myelitis  or  meningitis  supervene.  In 
the  absence  of  sudden  access  of  trouble,  the  symptoms  are  those 
of  a  slow  increase  of  motor  troubles  (local  paresis,  paralysis, 
paraplegia),  or  sensory  ( hyperaesthesia,  anaesthesia).  Spasms 
may  occur  early  or  even  later  in  the  disease.  From  disorder  due 
to  cerebral  lesions  the  morbid  phenomena  are  distinguished  by 
being  paraplegic  rather  than  hemiplegic ;  sensori-motor  rather  than 
sensory  or  motor ;  local  rather  than  general ;  with  intelligence 
and  special  senses  clear,  rather  than  dull  or  abolished ;  associated 
with  marked  muscular  atrophy  in  the  afiFected  parts ;  advancing 
from  behind  forward  rather  than  uniform  throughout  the  body. 


Slaw  Compression  of  Spinal  Cord.     Paralysis,  179 

The  area  of  nervous  disorder  points  more  or  less  clearly  to  the 
seat  of  the  lesion.  Early  implication  of  the  fore  limbs,  and  then 
later  of  the  hind,  suggests  lesion  of  the  cervical  region.  Dyspncea 
tumultuous  heart  action,  or  vertigo  may  coincide.  Tardy  move- 
ments of  the  hind  limbs,  imperfect  balancing,  dragging,  swaying, 
knuckling,  involuntary  flexions  of  stifle  or  hock,  flexor  con- 
tractions, standing  on  toe,  cramps,  paraplegia,  indicate  lesion  'in 
the  dorsal  or  lumbar  region.  There  may  be  palsy  of  the  rectum, 
anus,  bladder,  sphincter  vesicae,  penis,  and  vulva.  Paralysis  or 
other  nervous  disorder  of  the  tail  and  sphincters  ani  and  vesicae, 
without  implication  of  the  hind  limbs  or  quarters,  may  bespeak 
lesion  in  the  terminal  end  of  the  spinal  cord. 

With  paralysis  of  the  bladder  the  penis  may  be  pendent  out  of 
the  sheath,  or  being  retained  within  it,  the  urine  may  dribble 
constantly  into  and  from  that  cavity,  and  the  vulva  may  be  soft 
and  flaccid.  When  the  anus  is  involved,  the  adjacent  part  of 
the  rectum  usually  participates  becoming  overloaded,  the  sphincter 
is  soft  and  lax  and  allows  a  constant  oozing,  and  the  exposure  of 
the  mucosa.  The  paralytic  tail  hangs  between  the  thighs,  limp 
and  flaccid,  and  becomes  saturated  with  manure  and  in  females 
with  urine. 

Even  in  the  earlier  stages  the  symptoms  are  usually  greatly 
aggravated  by  compulsory  movements  like  turning  in  a  circle, 
walking  up  hill,  or  (in  dogs)  up  a  stair,  and  the  arched  back,  the 
pendent  head,  and  hesitating  planting  of  the  foot  suggests  walk- 
ing on  pins.  For  a  more  exact  localization  of  the  lesion  the 
reader  may  consult  the  table  indicating  the  functions  of  the 
different  parts  of  the  spinal  cord.  The  early  fatigue  under  exer- 
cise grows  as  in  other  progressive  spinal  lesions. 

Treatment,  In  most  cases  this  is  hopeless.  Tumors,  bony  and 
calcic  growths,  tubercles,  degenerations  and  absorption  of  nervous 
tissue  are  practically  beyond  remedy.  A  blood  extravasation 
may  be  largely  absorbed,  leaving  only  the  permanent  changes  in 
the  nervous  tissue.  In  this,  time  is  the  main  element.  Actino- 
mycosis may  sometimes  be  successfully  met  by  a  course  of  potas- 
sium iodide,  when,  if  the  nervous  lesions  are  slight,  a  fair  re- 
covery may  be  secured.  In  the  majority  of  cases,  however,  the 
practitioner  is  limited  to  measures  for  palliation  of  suffering  by 
atropia,  chloral,  phenacetin,  etc.,  or  by  nerve  stimulants  like 


i8o  Veterinary  Medicine. 

nux  in  small  doses,  or  by  weak  currents  of  electricity.  In  meat 
producing  animals,  it  is  often  the  best  course  to  fatten  rapidly, 
or  to  turn  over  at  once  to  the  butcher. 


DILATATION  OF  THE  CENTRAL  CANAL  OF  THE 
SPINAL  CORD.     SYRINGOMYELIA. 

This  means  literally  a  cavity  in  the  spinal  cord  but  is  applied 
to  cavities  formed  by  dilatation  of  the  central  spinal  canal,  or  by 
an  excavation  in  the  nervous  tissue  immediately  adjacent  and 
usually  communicating  with  a  dilated  segment  of  the  canal.  In 
man  it  is  usually  the  result  of  an  active  proliferation  of  the 
epithelial  cells  of  the  canal,  blocking  the  same,  or  extending  into 
the  adjacent  nervous  tissue  in  the  form  of  a  glioma.  In  difiFerent 
cases  in  dogs  it  occurred  as  the  result  of  pressure.  It  has  been 
seen  in  dogs,  cats  and  Guinea  pigs,  as  a  casual  lesion  and  as  the 
result  of  experiment. 

In  a  case  reported  by  Lienaux  it  extended  for  practically  the 
whole  length  of  the  cord,  varying  in  form  and  size  at  different 
points.  In  the  lumbar  portion  it  was  only  slightly  dilated,  in  the 
dorsal  it  was  very  irregular  with  prolongations  into  the  gray  mat- 
ter, toward  the  cervical  enlargement,  its  transverse  section  re- 
sembled an  inverted  V,  and  in  the  anterior  cervical  part  it  was 
unevenly  rounded.  Notable  changes  were  cell  proliferation  and 
subsequent  degeneration  with  the  formation  of  cavities,  thicken- 
ing of  the  neuroglia,  and  compression  and  even  obliteration  of 
the  vessels  with  circumscribed  areas  of  necrosis,  terminating  also 
in  cavity  formation. 

Symptoms.  These  vary  with  the  nervous  structures  invaded, 
atrophied  or  destroyed.  Invasion  of  the  anterior  horns  of  gray 
matter,  causes  trembling  and  muscular  wasting.  The  implication 
of  the  superior  horns  determines  more  or  less  marked  anaesthesia. 
Hyperaesthesia,  spasms,  paresis  and  paraplegia  are  also  seen  but 
no  symptom  nor  group  of  symptoms  is  diagnostic  of  the  exact 
lesion. 

Treatment  is  manifestly  hopeless. 


NEURASTHENIA  IN  PREGNANT  EWES. 

Canses :  inactmty,  lowered  miuciilar  and  nenrons  tone,  twin  pregnancy, 
approach  of  parturition ,  dry  (doyer  ha j)  ration ,  concurrent  diieanfa  Symp- 
toms :  moping,  anorexia,  depreaaion,  stupor,  blindness,  paresis,  lethargy. 
Prevention  :  open  air  life,  ezerdse,  high  muscular  condition,  avoidance  of 
debilitating  and  relaxing  conditions.  Treatment :  hygienic,  nerve  tonics, 
attend  to  concurrent  diseases. 

Neurasthenia  has  been  defined  as  an  incompetency  of  the 
nervous  system,  leading  to  early  fatigue,  and  inability  to  recuper- 
ate from  the  prostrate  condition.  Pending  a  better  knowledge  of 
the  affection.  I  have  given  this  name  to  an  asthenic  affection  seen 
in  pregnant  ewes  when  nearing  the  completion  of  the  period  of 
gestation. 

Causes.  In  a  large  number  of  cases  I  have  found  several  con- 
ditions so  constant,  not  to  say  invariable,  that  they  seem  to  de- 
serve special  attention  in  the  list  of  causes  : 

1st.  Enforced  inactivity.  In  every  instance  that  has  come 
under  my  notice  the  ewes  have  been  confined  for  several  months 
to  a  bam  or  at  most  a  confined  yard  so  that  exercise  became  im- 
possible. The  muscular  system  was  flabby  and  soft,  although  as 
a  rule  there  was  abundance  of  fat,  and  the  number  of  red  globules 
did  not  vary  much  from  the  normal.  In  an  animal  that  is  natur- 
ally so  active,  and  so  accustomed  to  outdoor  life  the  reduction  of 
tone  and  vigor  is  to  be  expected.  The  same  evil  shows  in  other 
directions,  thus  after  a 'snowy  winter  and  close  confinement  the 
crop  of  lambs  will  sometimes  perish  of  goitre  without  exception, 
while  in  subsequent  years,  with  enforced  exercise  of  the  ewes, 
practically  all  escape. 

2d.  Twin  lambs  have  been  found  in  the  womb  of  almost  every 
case  examined.  The  extra  drain  upon  the  system,  and  the  de- 
pressing action  of  the  load  on  an  atonic  ewe  together  with  the 
symptomatic  irritation  are  to  be  noted. 

3d.  The  near  approach  of  the  completion  of  gestation,  the 

cumulative  effect  of  a  long  pregnancy , and  perhaps  the  absorption  of 

metabolic  products  from  the  f cetal  membranes  in  course  of  prepar- 

tion  for  detachment,  and  of  leucomaines  from  the  physiologically 

181 


1 82  Veterinary  Medicine, 

active  or  developing  mammae,  doubtless  have  a  prostrating  influ- 
ence on  the  susceptible  nervous  system. 

4th,  All  had  been  fed  on  clover  hay  either  as  an  exclusive  diet 
or  as  part  of  their  ration.  This  is  sufficiently  nutritive,  as  testi- 
fied by  the  fat  condition  of  the  patients,  but  it  may  be  that  it  was 
too  nitrogenous  for  such  an  inactive  life.  Again  the  clover  hay 
usually  aboiiiids  in  cryptogams  and  bacteria  and  their  products, 
which  may  have  contributed  somewhat  to  the  asthenia. 

5th.  Concurrent  diseases,  in  individual  cases  or  flocks,  mani- 
festly contributed  to  the  general  loss  of  nervous  power.  In  some 
the  bowels  were  studded  with  the  nodules  of  the  oesophagostoma, 
in  others  oestrus  larvse  had  extensively  invaded  the  nasal  sinuses,- 
one  had  congestion  of  the  mucosa  of  the  small  intestines,  some 
had  congestion  and  fatty  degeneration  of  the  liver,  others  had 
fatty  kidneys,  and  one  had  a  papilloma  pressing  on  the  spinal 
cord.  Manifestly  diseases  and  degenerations  of  various  kinds 
would  still  further  undermine  nervous  energy  and  add  to  the 
atony. 

Cold  and  heat  did  not  seem  to  dominate,  as  most  were  kept  in 
warm  bams,  and  wore  heavy  winter  fleeces,  while  one  clipped 
early  in  December,  and  kept  in  an  atmosphere  40®  to  55°,  was 
attacked  in  the  second  week  of  January. 

As  this  experience  was  had  in  a  goitre  district  it  may  become  a 
question  whether  the  poison  of  this  disease  was  a  causative 
factor.  Goitre  was  not  a  prominent  feature  in  either  ewes  or 
lambs. 

Symptoms,  Variable.  The  most  prominent  are,  leaving  the 
flock,  moping  alone,  grinding  the  teeth,  drooping  and  trembling 
of  head  and  ears,  temperature  normal  or  subnormal  (100.5®), 
respiration  24,  pulse  80,  feeds  and  ruminates  sparingly,  bowels 
normal,  buccal  mucosa  pale,  conjunctiva  hyperaemic,  in  some 
cases  stupor  and  partial  blindness,  the  animal  walking  against 
racks  or  fences,  walk  is  slow  and  unsteady,  the  muscles  feel  soft 
and  flabby,  the  abdomen  may  be  full,  but  its  walls  are  quite 
flaccid  so  that  the  lambs  can  be  easily  felt.  As  the  disease  ad- 
vances all  symptoms  are  aggravated,  food  is  no  longer  taken, 
rumination  ceases,  the  ewe  remains  recumbent,  cannot  be  made 
to  rise,  and  when  lifted  and  carried  makes  no  struggle.  After 
24  hours  of  this  helpless  condition  death  supervenes.     In  some 


Neuritis,      Perineuritis,  183 

instances  labor  pains  have  come  on  and  the  ewe  has  perished  in 
a  vain  effort  at  delivery.     Illness  lasted  about  a  week. 

Prominent  lesions  have  been  noted  under  causes.  It  need  only 
be  added  that  no  notable  difference  from  the  normal  was  found 
in  making  a  count  of  the  red  globules,  and  the  size  of  the  in- 
dividual globule  was  normal  or  only  perceptibly  smaller  as  is  to 
be  expected  in  a  dense  plasma.  In  different  cases  there  was 
found  congestion  of  the  abomasum,  small  intestine,  liver  and 
brain. 

Prevention,  The  most  important  measure  is  to  maintain  a 
strong,  well-developed  muscular  system,  and  a  vigorous  nervous 
tone  by  a  sufficiency  of  out  door  exercise  during  the  winter 
months.  Half  a  mile  or  a  mile  at  least  should  be  given  daily  to 
the  breeding  ewes,  no  matter  what  the  attendant  difficulties.  If 
clover  hay  is  musty  it  should  be  replaced  in  whole  or  in  part  by 
another  kind.  Parasites  and  other  diseases  which  tend  to  lower 
the  general  tone  should  be  appropriately  treated. 

Treatment,  When  once  established,  the  disease  has  not  been 
successfully  treated.     Nerve  tonics  are  indicated. 


NEURITIS.     PERINEURITIS. 

Definition.  Causes :  traum&t,  poke,  stanchions,  collar,  yoke,  interfering, 
neurectomy,  fractures,  tumors,  callus,  rheumatism,  gout,  violent  over-dis- 
tension. Lesions :  nerve  sheath  red,  swollen,  exudate,  leucocytes  in  excess, 
fibroid  thickening,  nerve  atrophy,  degeneration,  axis  granular,  myelin  in 
oily  globules,  peripheral  extension.  Muscular  degeneration  and  atrophy. 
Symptoms  :  tenderness,  swelling,  muscular  atony,  wasting,  spasms,  twitch- 
ing, decreased  excitability,  paralysis,  in  section  swelling  on  proximsl  end. 
Prognosis  :  disability  for  weeks,  months  or  year ;  response  to  electric  cur- 
rent, operability  of  tumors,  curability  of  rheumatism  or  gout,  hopeful  con- 
ditions ;  long  standing  degeneration,  etc.,  unpromising.  Treatment :  rest, 
soothe,  anodynes,  splint  with  soft  pad,  essential  oils,  lead  and  opium  lotion, 
ice,   snow  ;  derivatives ;  laxatives ;  diuretics,  anti-rheumatics.  Faradisation. 

Definition,  Inflammation  of  a  nerve  leading  to  paralysis  of 
the  parts  to  which  it  is  distributed. 

Causes,  Traumatism  is  the  most  common  factor.  Among  the 
common  examples  are  injury  of  the  seventh  nerve  above  the 


184  Veterinary  Medicine, 

angle  of  the  lower  jaw,  by  a  poke  worn  in  pasture  by  the  horse, 
or  by  stanchions  in  the  cow.  Hogs  may  sufiFer  from  blows  of  the 
triangular  neck  gear  worn  to  prevent  them  from  breaking  through 
fences.  Blows  by  the  yoke,  incised  and  contused  wounds  implicat- 
ing the  nerve,  such  as  neurectomy,  and  the  blows  received  in  in- 
terfering, and  compression  by  tumors  or  bony  growths,  are 
familiar  examples.  Fractures  with  displacement,  notably  those 
of  the  sacrum  and  proximal  end  of  the  coccyx  with  caudal  paraly- 
sis, are  not  uncommon.  In  fractures  of  the  limbs  the  pressure 
upon  or  wounding  of  a  nerve.  Again,  the  callus  on  the  seat  of 
fracture  may  induce  neuritis  by  pressure  as  may  also  the  projec- 
tion of  the  end  of  a  bone  in  luxation.  Rheumatism  affecting  the 
nerve  sheaths  and,  in  birds  and  swine,  gout,  are  additional 
factors.  Violent  overdistension,  and  even  chronic  muscular 
spasm,  are  quoted  as  causes. 

Lesions.  The  early  changes  are  mainly  in  the  connective  tissue 
sheath,  which  becomes  h5rperaemic,  red  and  swollen,  with  a  gela- 
tinoid  exudate  and  a  great  multiplication  of  leucocytes.  Later, 
the  interfibrillar  connective  tissue  is  involved  and  the  nervous 
substance  proper  undergoes  hyperaemia  and  degeneration.  The 
axis  cylinder  undergoes  granular  degeneration  and  the  myelin 
breaks  up  into  oil-like  globules.  The  lesions  are  at  first  limited 
in  extent,  though  there  may  be  more  than  one  focus,  and  the  re- 
sulting degeneration  of  the  nervous  filaments  advances  toward 
the  periphery  in  accordance  with  Waller's  law  by  which  disease 
changes  proceed  rapidly  in  parts  cut  off  from  their  trophic  cells. 

The  muscles  supplied  by  the  inflamed  nerves  also  rapidly 
degenerate.  The  fibres  shrink  in  size,  and  lose  their  striated 
appearance,  becoming  distinctly  granular,  and  pale.  Round  cells 
are  formed  in  excess  in  the  sarcolemma  and  muscular  fibre,  and  if 
the  morbid  condition  persists  there  is  fibroid  degeneration,  cir- 
rhosis and  contraction. 

Symptoms,  In  the  absence  of  the  subjective  element  of  pain, 
which  is  the  most  constant  symptom  in  man,  we  must  rely  mainly 
on  the  exquisite  tenderness  on  pressure  along  the  line  of  the 
nerve,  but  localized  at  some  particular  point,  on  the  swelling  at 
such  tender  point  and  on  the  loss  of  muscular  power  or  even  of 
sensation  in  the  tissues  corresponding  to  its  peripheral  distribu- 
tion.    The  muscles  may  be  hypersensitive  and  are  usually  flaccid 


Neuritis,     Perineuritis  185 

if  not  from  actual  paralysis,  still  from  the  pain  which  attends  on 
their  contraction.  In  some  cases  they  are  the  seat  of  clonic 
spasms  or  twitching.  Under  a  current  of  electricity  they  show  a 
decreased  irritability  which  bears  a  direct  relation  to  the  grade  of 
degeneration  which  has  occurred  in  the  nerve  fibres.  In  cases  of 
deep-seated  neuritis  paralysis  may  be  the  only  appreciable  symp- 
tom. In  traumatic  injuries  like  bruises  of  the  seventh  nerve 
or  fracture  of  the  sacrum  the  local  swelling  and  tenderness  are 
marked  initial  symptoms,  upon  which  supervene  the  paralysis  and 
atrophy  of  the  muscles  cut  off  from  full  innervation.  In  neurec- 
tomy the  tender  swelling  in  the  stump  which  is  still  in  connection 
with  the  nerve  centre  may  amount  to  a  distinct  neuroma,  while 
the  peripheral  and  detatched  portion  of  the  nerve  steadily  loses  its 
irritability  as  shown  by  electric  stimulus. 

Prognosis.  This  will  depend  on  the  nature  of  the  lesions.  A 
single  transverse  section  of  a  nerve,  without  loss  of  substance  may 
be  repaired  in  a  few  months,  while  with  loss  or  degeneration  of  a 
considerable  part  of  its  substance  it  may  maintain  a  paralysis  for 
years  or  even  permanently.  Lesions  due  to  slight  bruises  may 
recover  in  a  few  weeks,  while  the  more  severe  ones  will  persist  for 
months  or  years.  The  response  to  electric  stimulus  distal  of  the 
lesions,  is  a  guarantee  of  the  absence  of  degeneration  and  a  feature 
hopeful  of  recovery.  Pressure  by  bony  displacement  or  neoplasia 
must  be  done  away  with  as  the  first  condition  of  improvement  in 
such  cases.  Rheumatic  and  gouty  cases  will  persist  until  these 
constitutional  infirmities  are  corrected. 

If  the  neuritis  and  paralysis  have  lasted  for  any  length  of  time, 
the  degeneration  of  the  muscles  will  keep  up  a  degree  of  muscular 
weakness  (and  if  in  the  limbs  lameness)  after  the  repair  of  the 
nerve  has  been  completed. 

Treatment.  Rest  is  the  first  consideration  accompanied  by 
soothing  and  anodyne  application  to  the  inflamed  nerve.  When 
neuritis  exists  in  a  limb  a  softly  padded  splint  may  be  useful  at 
first.  The  skin  over  the  inflamed  nerve  may  be  rubbed  by  one 
or  a  combination  of  the  anodyne  essential  oils,  (oil  of  cajeput,  oil 
of  peppermint,  oil  of  lavender).  If  the  pain  and  tenderness  are 
extreme,  a  bag  of  ice  or  snow  may  give  relief  and  should  be  kept 
applied  for  a  length  of  time.  Or  hot  fomentations  with  a  lotion 
of  lead  and  opium  may  be  preferred  especially  in  rheumatic  cases. 


1 86  Veterinary  Medicine. 

If  blisters  seem  to  be  called  for,  aqua  ammonia  and  oil  of  turpen- 
tine may  be  added  to  the  essential  oils,  or  muriatic  acid  may  be 
applied  with  a  glass  rod  in  points  along  the  line  of  nerve.  A 
laxative  of  Epsom  or  Glauber  salts  will  often  prove  of  great  value 
at  the  outset  and  may  be  followed  by  diuretic  doses  of  potassium 
iodide,  potassium  nitrate  or  acetate,  and  in  rheumatic  cases 
sodium  salicylate.  In  these  last  forms,  as  also  in  gout,  the  car- 
bonates and  acetates  of  the  alkalies,  colchicum,  and  salicylates  are 
especially  to  be  persisted  with.  In  these,  too,  rubefacients  and 
blisters  are  often  of  essential  value  and  may  be  repeated  again 
and  again. 

Faradism  is  of  little  account  during  the  active  stage  of  neuritis 
excepting  as  a  test  of  the  progress  and  extent  of  the  degeneration, 
but  when  inflammation  has  subsided  nothing  contributes  more  ta 
the  restoration  of  the  tone  and  healthy  nutrition  of  both  nerve 
and  muscle.  The  current  is  to  be  sent  along  the  line  of  the  pare- 
tic nerve  and  muscles  for  ten  or  fifteen  minutes  at  a  time  and  not 
less  than  once  a  day. 


NEURALGIA. 


Intermittent  or  remittent  pains,  in  line  of  nerve  without  inflammation,  or 
other  structural  lesion.  Diagnosis :  lameness,  stiffness  of  particular  mus- 
cles having  a  common  nerve.  Unnatural  position  habitual.  Pain  of  inflam- 
mation and  of  neuralgia.  No  functional  change.  Rheumatism.  Tumors. 
Causes  :  lead,  rheumatism,  gout,  auto-poisons,  cold,  aosemia,  reflex.  Facial 
neuralgia,  occipitocervical,  dorso-intercostal,  lumbo-abdominal,  sciatic 
Treatment:  elimination,  of  lead,  etc.  ;  intestinal  antiseptics,  tonics,  hot 
water,  anodynes,  arsenic 

This  is  characterized  by  pain  paroxysmal,,  intermittent  or  re- 
mittent situated  in  the  course  of  given  nerves.  It  must  be  a  pure 
neurosis  and  unaccompanied  by  any  specific  structural  lesions  like 
inflammation,  degeneration,  atrophy,  hypertrophy,  tumor  or  the 
like.  It  is  therefore  manifested  subjectively  and  cannot  be  easily- 
identified  in  the  lower  animals.  Nevertheless,  Lafosse,  Zundel, 
Gen^e,  and  others  have  recorded  cases,  their  conclusion  being  de- 
ducedirom  symptoms  which  were  held  to  indicate  nervous  suffer- 


Neuralgia.  187 

ing  in  the  absence  of  any  structural  lesion  whatever.  A  priori 
one  can  with  difficulty  escape  the  con\nction  that  neuralgia  must 
exist  in  the  lower  animals  as  in  man,  and  the  only  drawback  to  its 
recognition  is  the  difficulty  of  diagnosis. 

The  first  step  in  such  diagnosis  must  usually  be  the  presence  of 
lameness,  stiffness  or  indisposition  to  free  movement  of  some  par- 
ticular muscle  or  group  of  muscles  deriving  their  innervation  from 
a  particular  nerve.  Or  there  may  be  a  particular  position  habitu- 
ally assumed  such  as  semi-dosed  eyelids,  drawn  back  ears,  laterally 
inclined  neck  which  strongly  suggests  nervous  suffering.  Next, 
there  must  be  the  exclusion  of  any  appreciable  structural  cause 
and  especially  of  inflammation.  The  three  prominent  features  of 
the  pain  of  inflammation  is  that  it  is  aggravated  by  pressure,  it  is 
heightened  by  movement,  and  it  is  accompanied  by  some  decided 
alteration  of  the  function  of  the  part.  If  there  are  at  the  same 
time  exudation  and  swelling,  inflammation  is  all  the  more  certainly 
indicated.  In  a  neuralgic  pain  on  the  contrary  pressure  does  not 
increase  the  pain  :  it  may  even  alleviate  it :  movement  of  the  part 
may  be  rather  satisfactory  to  the  patient  than  painful ;  and  the 
disturbance  of  function,  contractile,  secretory,  trophic,  is  not  per- 
ceptible. There  is  no  local  exudation  nor  swelling  to  account  for 
the  nervous  disorder. 

The  liability  to  confound  the  affection  with  a  neuritis  more 
centrally  situated,  but  the  pain  of  which  is  referred  to  the  peri- 
phery of  the  nerve,  is  to  be  obviated  by  a  tracing  of  the  nerve 
along  its  course  to  the  nerve  centre  so  as  to  identify  any  centre  of 
tenderness,  and  also  by  the  implication  of  all  the  peripheral 
branches  coming  off  ectal  of  that  point. 

Again,  rheumatism  may  be  easily  confounded  with  neuralgia, 
but  here  the  affected  nerve  and  muscle  and  even  the  skin  over  it 
is  liable  to  be  very  tender  to  the  touch  or  pinch,  and  if  at  all 
acute  some  hyperthermia  is  present.  Like  rheumatism,  neuralgia 
shows  a  tendenc}'  to  shift  from  place  to  place. 

Pains  due  to  pressure  on  the  nerves  by  tumors,  aneurisms,  and 
other  swellings,  are  constant,  whereas  neuralgic  pains  are  marked 
by  remissions  and  aggravations  and  even  by  intervals  of  complete 
relief. 

Causes.  The  toxic  neuralgias  are  illustrated  by  chronic  lead 
poisoning,  in  which,  in  man,  there  are  wandering  pains  like  those 


1 88  Veterinary  Medicifie, 

of  rheumatism,  and  in  the  lower  animals  muscular  stiffness  and 
contractions  which  suggest  a  similar  condition.  In  man,  too, 
gout  is  a  common  factor,  and  in  pigs  and  birds  in  which  this  con- 
dition exists,  stiffness  and  evidence  of  suffering  may  well  be  at 
times  attributed  to  a  similar  cause.  How  many  other  forms  of 
chronic  metallic  poisoning  and  poisoning  by  morbid  autochtho- 
nous products  of  indigestion  are  attended  by  disorders  of  innerva- 
tion and  nutrition,  it  is  as  yet  impossible  to  say.  The  direct 
action  of  cold,  an  anaemic  condition  of  the  nerves,  and  reflex 
action  from  distant  sources  of  irritation  are  among  the  other  in- 
voked causes.  Inflammation  in  the  nervi  nervorum  is  also  invoked 
as  a  factor,  but  in  this  case  the  symptoms  would  not  accord  with 
the  rule  given  above,  since  the  nerve  trunks  would  be  very  tender 
to  touch  or  pressure,  and  the  suffering  would  be  unshifting  and 
shown  permanently  in  the  one  seat. 

Facial  Neuralgia.  I^afosse  and  Zundel  describe  as  cases  of 
this  kind  those  in  which  periodically  the  horse's  eyes  are  fixed 
and  shining,  the  ears  drawn  back  and  depressed  as  in  vice,  the 
head  at  intervals  bent  on  the  neck,  with  plaintive  neighing,  rub- 
bing the  head  on  the  stall  and  pawing.  Those  cases  of  twitching 
of  the  head  or  rapid  jerking  of  the  ears  in  horses,  when  they 
have  been  driven  for  some  distance,  and  which  are  relieved  by 
wearing  a  close  net  over  the  nostril  or  by  section  of  the  trifacial 
nerve  at  the  infra-orbital  foramen,  manifestly  partake  of  this 
character. 

Cervico-Occipital  Neuralgia.  I^afosse  speaks  of  this  as 
often  mistaken  for  torticolis,  the  head  being  turned  to  the  af- 
fected side  during  the  paroxysms.  In  man  this  is  often  a  result 
of  cold  draughts  on  the  back  of  the  head,  and  associated  with 
tender  points  on  the  course  of  the  nerve,  between  the  mastoid 
and  the  median  line. 

Dorso-intercostal  neuralgia  causes  pain  in  deep  inspiration, 
and  lumbo-abdominal  neuralgia  develops  tenderness  in  the 
loins,  in  one  testicle,  or  in  one  lip  of  the  vulva  according  to 
Lafosse.  Diagnosis  between  such  cases  and  neuritis,  spinal 
disease,  and  other  obscure  nervous  affections  must  be  very 
problematical. 

Sciatic  Neuralgia.  This  is  described  by  Zundel  as  causing 
jerking  and  lameness  in  the  affected  limb,  sometimes  aggravated 


Neuralgia.  189 

and  sometimes  improved  by  work  and  associated  with  muscular 
weakness  or  paresis.  Sciatica  in  man  is,  however,  rarely  a 
simple  neuralgia,  but  partakes  rather  of  the  nature  of  a  neuritis, 
and  there  is  no  good  reason  for  supposing  that  the  disease  of  this 
nerve  in  the  lower  animals  is  other  than  an  inflammatory 
condition. 

Ledainche  after  consideration  of  the  testimony  adduced,  is  of 
the  opinion  that  we  still  lack  absolute  evidence  of  uncomplicated 
neuralgia  in  the  domestic  animals. 

Treatment,  For  toxic  cases  elimination  of  the  poison  is  the 
first  consideration.  For  lead  carefully  graduated  doses  of  iodide 
of  potassium  to  carry  off  the  offending  agent  without  increasing 
its  poisonous  action  must  be  continued  as  long  as  the  metal  is 
passed  by  the  urine.  It  may  be  followed  by  a  course  of  strychnia, 
by  electricity,  massage  and  blisters.  Gouty  subjects  may  be 
treated  with  salicylate  of  soda,  alkalies,  or  colchicum.  The  vic- 
tims of  Bright* s  disease  must  be  treated  for  the  kidney  affection. 

Where  there  has  been  trouble  of  the  digestive  organs,  in- 
testinal antiseptics  (salol,  sodium  salicylate,  bismuth-salicylate, 
beta  napthol)  and  small  doses  of  arsenious  acid  will  sometimes 
benefit. 

In  anaemic  conditions  a  course  of  tonics  (cod  liver  oil,  iron, 
quinine,  nux  vomica)  are  indicated,  and,  to  improve  the  local 
blood  supply,  nitro-glycerine.  A  rich  stimulating  ration,  currying, 
an  open  air  life,  and  sunshine  (in  summer  a  run  at  grass)  are 
called  for. 

In  man  with  a  suspicion  of  traumatic  origin,  W.  H.  Thomson 
strongly  advocates  a  persevering  use  of  the  hot  water  douche  to 
the  parts  first  affected,  the  hypodermic  use  of  morphia  and 
atropia,  and  in  case  of  local  anaemia  nitroglycerine  every  three 
hours.  Where  there  is  a  suspicion  of  inflammation  he  success- 
fully employs  absolute  rest,  with  opium  narcotism  so  as  to  abolish 
the  pain,  for  twenty  da>-s  if  necessary.  Aconite,  antipyrin, 
acetanilid,  phenacetin.  exaglin,  and  gelsemium  have  their 
advocates,  and  may  benefit  in  individual  cases.  A  course  of 
arsenic  is  often  successful,  and  phosphorous  and  ergot  have  each 
proved  of  value. 


ATROPHY  OF  NERVES. 

Prom  arrest  of  fanction,  from  lesions,  pressure,  distal,  bat  at  times  central 
of  lesion.  Symptoms :  Loss  of  function  advancing  to  paralysis.  Muscle 
atrophy.  Prognosis :  in  absence  of  incurable  cause,  is  hopeful.  Union  of 
divided  ends,  restoration  of  function.  Treatment :  time,  ligature  of  divided 
ends. 

This  is  usually  the  result  of  arrest  of  function.  It  may  be  due 
to  transverse  section  of  the  nerve,  as  in  surgical  neurectomy  when 
the  separated  peripheral  end  of  the  nerve  gradually  wastes.  It 
may  come  from  contused  wounds  implicating  the  nerve  and  caus- 
ing destruction  of  its  substance.  It  may  be  from  tumors  or  other 
neoplasms  pressing  on  the  trunk  of  the  nerve  and  preventing  the 
passage  of  nerve  currents.  Or,  inflammatory  effusion  may  press 
on  the  nerve,  as  happens  often  to  the  crural  in  hsemoglobinuria. 
Or  the  pressure  may  come  from  enlarged  mediastinal  glands,  or 
even  from  the  distended  posterior  aorta  under  habitual  violent 
exertion  so  as  to  permanently  incapacitate  and  atrophy  the  left  re- 
current laryngeal  nerve  as  in  chronic  laryngeal  paralysis  (roaring) . 
Similar  wasting  occurs  in  other  nerves  under  corresponding  con- 
ditions. Atrophy  may,  however,  extend  centrally  from  the  peri- 
pheral end  of  a  nerve  when  it  can  no  longer  remain  functionally 
active.  We  find  an  example  of  this  in  the  atrophy  of  the  optic 
nerve  up  to  the  commissure  when  the  eyeball  has  been  excised. 
A  similar  condition  is  often  seen  in  horses  in  which  the  integrity 
of  the  eye  has  been  completely  destroyed  in  connection  with  re- 
curring ophthalmia. 

The  symptoms  attendant  on  atrophy  of  a  nerve  are  those  of  im- 
paired function  gradually  advancing  to  complete  paralysis  of 
motion  or  sensation.  In  cases  of  a  complete  breach  of  continuity 
as  in  section  or  severe  traumatism  the  entire  loss  of  function 
necessarily  precedes  the  atrophy.  Again,  when  it  comes  from 
destructive  changes  in  the  coats  and  media  of  the  eye,  and  of  the 
ganglionic  cells  of  the  retina,  the  atrophy  of  the  nerve  trunk  pro- 
ceeds simultaneously  with  the  lesions  of  the  organ  of  vision. 

The  diagnosis  will  in  many  cases  be  easy  as  deduced  from  the 
traumatic  or  surgical  lesion.  In  other  cases  it  may  be  made  with 
190 


Atrapy  of  Nerves.  191 

certainty  from  the  complete  muscular  paralysis,  wasting  and 
degeneration  of  the  muscles  supplied  by  the  nerve,  and  by  the  his- 
tory of  the  case  (haemoglobinuria  in  atrophy  of  the  triceps  exten- 
sor cruris,  roaring  in  atrophy  of  the  laryngeal  muscles  and  recur- 
rent nerve).  In  other  cases,  as  in  the  eye,  we  have  the  atrophy 
of  the  eyeball,  the  distortion  or  complete  paralysis  of  the  iris,  the 
opacity  of  the  lens,  or  the  exudation  into  the  vitreous,  choroid  and 
retina  when  these  can  still  be  observed. 

Prognosis  will  depend  on  the  cause.  With  a  nerve  severed  with 
a  knife  or  crushed  in  a  part  of  its  course  and  atrophied,  without 
destructive  changes  in  the  organs  in  which  it  is  distributed,  repair 
is  possible  and  to  be  expected  in  time. 

TWa/m^n/ is  expectant,  yet  inflammation  must  be  subdued, 
tumors  removed,  divided  ends  ligatured,  etc. 


DISEASES  OF  THE  URINARY  ORGANS. 


Relative  prevalence  in  man  and  animals.  Causes  of  di£ference.  Kidneys  as 
eliminating  organs  for  nitrogenous  material,  toxins,  bacteria,  mineral,  veg- 
etable and  animal  poisons,  diuretic  drinking  water,  condition  powders^ 
cantharides,  urea,  etc.  Suppression  of  urine,  precipitation  of  urine.  Pil- 
tration  through  kidney.  Secretion.  Urinary  solids.  Nervous  control  of 
secretion.    Excess. 


Diseases  of  the  urinary  organs  are  less  prevalent  in  the  lower 
animals  than  in  man,  owing  largely  no  doubt  to  the  greater  sim- 
plicity of  their  habits  of  life  and  to  the  comparative  shortness  of 
the  lives  of  those  that  are  kept  for  meat  producing.  It  is  a  mis- 
take, however,  to  suppose  that  they  are  so  infrequent  as  would 
appear,  since  the  absence  of  subjective  symptoms  in  the  animal 
allows  a  number  of  the  milder  forms  of  renal  disease  to  be  passed 
over  without  recognition. 

In  man  the  excessive  consumption  of  animal  food,  the  lack  of 
exercise,  the  abuse  of  alcohol,  the  prevalence  of  veneral  diseases, 
conduce  largely  to  renal  troubles,  while  animals  in  general  escspe. 
Yet  animals  suffer  much  more  extensively  than  is  generally  sup- 
posed. The  kidneys  are,  as  in  man,  the  eliminating  organs  for 
superfluous  and  waste  nitrogenous  matter,  and  in  overfed  animals 
may  be  overcharged  with  this  work.  They  are  the  general 
emunctories  for  the  soluble  poisonous  products  of  bacteria  and 
plants,  which  may  stimulate  the  urinary  secretion,  and  from  these 
irritation  may  result.  It  is  through  the  kidneys  that  the  bacteria 
themselves  largely  leave  the  animal  body,  and  trouble  is  liable  to 
come  during  their  passage.  Further,  exposure  to  cold  tends  to  in- 
crease the  urinary  secretion,  over-stimulating  the  kidneys,  and 
the  same  may  come  from  diuretic  drinking  waters  and  condition 
powders,  also  from  cantharides  and  other  diuretic  agents  applied 
to  the  skin.  Urea  and  many  toxins  are  diuretic,  hence  the  oc- 
currence of  polyuria  at  and  after  the  crisis  of  fevers. 
192 


Diseases  of  the  Urinary  Organs.  193 

On  the  other  hand  suppression  of  the  urinary  secretion 
may  occur  in  connection  with  profuse  perspirations  in  hot  weather, 
with  prolonged  diarrhoea,  or  with  privation  of  water,  and  in  such 
cases  the  liquid  becomes  concentrated  and  irritating  and  there 
is  a  disposition  to  precipitate  its  solids  under  slight  disturbing 
causes.  As  conducive  to  such  precipitation  may  be  named 
foreign  solid  bodies,  bacterial  ferments  and  probably  the  goitre 
poison  since  gravel  and  calculus  are  common  in  goitrous  regions. 

There  are  two  forms  of  elimination  through  the  kidneys. 
I ,  filtration  ;  2 ,  secretion .  ^ 

1.  Filtration  is  referred  to  the  glomeruli,  and  is  determined  by 
the  relative  blood  pressure.  Increase  of  pressure  causes  increase 
of  watery  transudation.  Digitalis  increases  heart  action  and 
arterial  pressure,  and  accidentally  urination.  Excessive  consump- 
tion of  water  and  watery  liquids  increases  intravascular  ten- 
sion, and  the  amount  of  urine. 

2.  Secretion  is  referred  to  the  columnar  epithelium  of  the 
convoluted  tubes.  It  is  by  the  elective  aflSnity  or  selective 
power  of  this  epithelium  that  the  solids  of  the  urine  are  ab- 
stracted from  the  blood  and  passed  into  the  urine.  Crystals  of 
uric  acid  have  been  found  in  these  cells  and  it  is  supposed 
that  the  abundance  of  water  furnished  by  the  glomeruli,  irri- 
gating these  convoluted  tubes,  dissolves  and  washes  on  the 
various  solids  and  other  products  with  which  the  epithelial  cells 
are  charged.  The  protoplasm  of  the  cells  becomes  saturated 
with  the  urea,  uric  acid,  hippuric  acid  coloring  matter  (indican, 
urochrome,  etc.),  and  this  is  washed  out,  passing  by  exosmosis 
to  the  liquid  of  lesser  density  with  which  the  tubes  are  filled. 

Nervous  Control  of  Urinary  Secretion. 

An  electric  current  through  the  renal  plexus  of  the  sym- 
pathetic (vaso-motor)  lessens,  or  suppresses  urinary  secretion 
(inhibition). 

Cutting  the  nerves  of  this  plexus  causes  excessive  vaso-di- 
lation,  renal  pulsations  synchronous  with  heart  beats  and  arterial 
pulse,  and  great  increase  of  urine.  A  similar  increase  comes 
from  the  application  of  cold  to  the  surface,  from  fatigue,  from 
heat  exhaustion,  from  irritation  of  the  floor  of  the  fourth  ventricle 
13 


194  Veterinary  Medicine, 

just  in  front  of  the  origin  of  the  vagus  and  from  section  of  the 
splanchnic  nerve.  This  last  is,  however,  much  less  marked  and 
more  transient  than  from  section  of  the  renal  nerve  noted  above  ; 
the  latter  causing  dilation  of  the  renal  vessels  only,  and  increased 
pressure,  whereas  the  former  causes  dilation  of  the  abdominal 
organs  generally,  diverting  the  blood  largely  to  other  parts  than  the 
kidney  and  preventing  the  same  increase  of  pressure  in  the  vessels 
of  the  latter.  For  the  same  reason  transverse  section  of  the  medulla 
oblongata,  or  of  the  spinal  cord  as  far  back  as  the  seventh  cervical 
vertebra,  lessens  or  interrupts  the  urinary  secretion,  the  pressure 
in  the  kidney  being  reduced  by  the  diversion  of  much  of  the 
blood  elsewhere.  This  influence  of  the  nervous  system  on  the 
urinary  secretion  seems  to  be  mainly  or  entirely  one  of  increase 
or  decrease  of  blood  pressure  in  the  kidney.  For  this  reason  a 
weak  heart  tends  to  lessen  urinary  secretion. 

Excessive  increase  of  urine  is  only  important  when  con- 
tinuous and  in  the  absence  of  visible  cause,  such  as  diuretics. 


PHYSICAL  PROPERTIES  OF  THE  URINE. 

Color,  yellow,  red,  brown  ;  horse,  ox,  calf,  sheep,  goat,  dog,  cat,  bird. 
In  disease  :  pale  yellow,  with  water  in  excess;  deep  yellow,  red,  brown  with 
solids  in  excess,  urobiline,  biliverdin,  hsemoglobin .  Extraneous  colors. 
Bilharzia.  Translncency  :  Turbidity  :  horse,  ruminants,  carnivora,  pig.  In 
disease,  horse,  other  animals.  Consistency,  viscous,  stringy,  tarry  ;  odor, 
horse,  dog,  cat,  ammoniacal,  foetid,  drug  odor.  Specific  gravity,  estimate  of 
solids  ;  reaction,  acid,  alkaline,  neutral ;  morbid  chemical  changes,  sodium 
chloride,  phosphate,  alkaline,  earthy,  indican,  urea,  uric  acid,  hippuric  acid, 
.phenol,  creatinin,  acetone,  oxalic  acid,  allantoin,  xanthin,  hypoxanthin, 
cyanuric  acid,  lencin,  albumen,  glucose,  bile  salts  and  pigments,  blood, 
hsemoglobin,  epithelium,  pus,  casts 

Color.  In  estimating  the  color  we  must  note  the  various 
shades  of  yellow,  red  and  brown  and  compare  these  with  the 
normal  in  different  genera  of  animals,  on  different  food  and 
water,  and  in  different  conditions  of  health.  Grades  of  color 
may  be-  stated  as  follows  : 

Yellow :  Pale,  clear  and  deep  yellows. 

Red  :  Reddish  yellow,  yellowish  red,  and  red. 


Physic€U  Properties  of  the  Urine.  195 

Brovirn  :  Brownish  red,  reddish  brown  and  brownish  black. 

Color  of  Normal  Urine.  This  varies  with  the  species  of 
animal,  food,  quantity  of  water  drunk,  and  time  of  retention  in 
the  bladder. 

Horse  :  Urine  is  normally  dear  yellow,  brownish  yellow,  or 
deep  citron  yellow,  and  the  color  is  deepened  by  rich  and  abund- 
ant food  (excess  of  solids)  and  by  exposure  to  the  air  (changes 
in  pigments).  It  may  be  sulphur  white  and  sedimentary  from 
precipitation  of  CaCO,  when  on  green  food. 

Ox,  Calf,  Sheep  and  Goat :  Normal  urine  clear  yellow  to 
wine  yellow.  In  the  ox  especially  it  is  a  pale  straw  tint,  but 
varies  to  a  deep  brown  on  nitrogenous  food  (clover,  peas,  beans, 
cotton  seed,  lentils,  pea  or  bean  straw).  Color  may  be  due  to 
indican  and  sometimes  to  indicanin  or  indigo  blue,  which  ex- 
plains the  blue  urine  sometimes  described. 

Dog  :  Normal  urine  is  yellow,  straw-colored,  aniline  yellow, 
honey  yellow,  to  brownish  yellow  in  hot  season  or  on  dry  nitro- 
genous food.     Is  always  relatively  deeper  than  in  ruminants. 

Cat :  Straw  yellow  to  honey  yellow,  with  variation  as  in  the  dog. 

Pig :  Very  pale  yellow,  more  highly  colored  on  dry  feeding, 
nuts,  peas,  etc. 

Birds  :  ^\^ite  or  yellow,  sedimentary.  Mixed  with  faeces  in 
cloaca. 

Color  of  Pathological  Urine :  Pale  yellow  with  excessive 
secretion  glycosuria,  polyuria,  cryptogamic  polyuria,  chronic  in- 
terstitial nephritis,  under  diuretics,  or  after  excessive  drinking. 
The  free  secretion  of  a  crisis  in  a  fever  is  pale  yellow. 

Deep  yellow,  deep  red,  deep  brown  color,  indicates  excess 
of  urinary  pigment  (urobiline)  and  is  deepened  by  nitric  acid. 
This  is  seen  in  all  hyperthermias  with  suppressed  or  diminished 
secretion,  in  privation  of  water,  or  food.  This  urine  is  acid  even 
in  herbivora. 

Yellow,  saffron  yellow,  brownish  yellow,  greenish,  olive, 
or  brownish  red  indicate  the  presence  of  bile  pig^ments  (biliver- 
din,  bilirubin)  as  in  jatmdice  or  cholyuria.  Bile  salts  should  be 
tested  for.  A  similar  coloration  may  come  from  free  consump- 
tion of  carrots,  or  other  yellow  pigmentary  matters. 

Red,  brownish  red,  blood  red,  or  deep  brown  color  im- 
plies the  presence  of  blood  or  blood  coloring  matter  in  the  urine 


196  Veterinary  Medicine, 

(hsematuria,  haemoglobinuria).  Exposed  to  the  air  this  becomes 
brown  or  chocolate  in  ratio  with  the  amount  of  blood  or  blood  pig- 
ment present.     Some  such  cases  are  complicated  by  blood  clots. 

Color  due  to  Foreign  Constituents. 

Bronze  or  black  color  may  come  from  injection  of  phenic 
acid. 

Deep  green  or  olive  green  may  come  from  tar,  carbolic 
acid,  salol,  creosote,  or  derivatives  of  benzine  taken  in. 

Brownish  green  comes  from  thallin  and  reddens  with  iron 
chloride. 

Brown  or  blood  red  from  rhubarb  or  senna. 

Purple  red  from  santonin,  if  alkaline  (if  acid,  is  reddish 
yellow). 

Red  from  madder  (it  is  alleged  from  indigo). 

Yellow  from  Carrots. 

Blue  (indigo  bine)  may  occur  in  urine  of  horse  or  ox  when 
exposed  to  the  air. 

Bluish  green  will  come  from  feeding  indigo. 

White  or  yellow  color  will  result  from  the  presence  of  pus. 

White  chylous  urine  occurs  with  a  haematozoon  (Bilharzia 
Crassa)  in  the  blood  of  cattle. 

Translucency .  Urine  may  be  passed  clear  and  become  turbid 
by  standing.  The  presence  of  colloids  hinders  precipitation  and 
prevents  clearing. 

Horse  :  Urine  is  generally  turbid,  especially  what  has  been 
long  in  the  bladder,  and  that  which  is  last  passed.  The  turbidity 
is  largely  due  to  precipitation  of  calcium  carbonate  and  bicar- 
bonate, and  increases  on  green  food,  or  if  the  liquid  stands  ex- 
posed to  the  air  and  is  cooled.  Not  unfrequently  the  salts  are 
thrown  down  as  fine  spherical  granules,  or  there  may  be  a  white 
pultaceous  mass.  They  are  sometimes  entangled  in  extremely 
mobile  cylindroid  masses  coming  from  the  uriniferous  tubes  during 
convalescence  from  fevers  or  during  fasting.  A  fine  pellicle  on 
the  surface  is  normal  in  horse's  urine  left  in  the  air. 

Ox,  sheep  and  goat  :  Urine  is  passed  clear.  May  become 
turbid  through  the  change  of  lime  carbonate  into  bicarbonate  in 
cattle  but  always  more  slowly  than  in  the  horse. 

Carnivora  :  Urine  is  passed  clear  but  becomes  turbid  on  decom- 
position, or  if  concentrated.     With  excess  of  fat  in  the  food  it 


Physical  Properties  of  the  Urine.  197 

• 

may  become  opaque  from  floating  oil  globules,  apart  from  the 
classic  chyluria. 

Pig  :  Fed  on  raw  fresh  vegetables  the  urine  is  clear,  but  if  on 
cooked  or  dried  Vegetables,  and  especially  if  nitrogenous,  it  may 
show  opacity. 

Pathological :  The  horse's  urine  is  limpid  and  acid  in 
polyuria  ;  limpid  and  alkaline  or  neutral  with  modified  phos- 
phates. It  may  be  morbidly  turbid  from  excess  of  lime  phosphate 
or  sulphate,  urea  or  other  add  salts,  exudates,  leucocytes  or  pus. 
These  usually  indicate  nephritis.  Mucus  and  muco-purulent 
exudate  suggest  pyelitis  or  pelvic  nephritis.  Blood  elements 
indicate  nephritis,  cystitis  or  urethritis.  Debris  of  kidney  tissue 
may  indicate  tuberculosis  ;  tumors,  etc. 

Turbidity  in  other  animals  than  solipeds  is  abnormal :  examine 
the  urine. 

Consistency  of  Urine.  Morbid  urine  may  be  gluey,  sizy, 
s)rrupy,  mucous,  oily.  If  a  horse's  urine  is  scanty  a  slight 
siziness  may  be  normal  and  due  to  tenacious  mucus  from  the 
pelvis  of  the  kidney,  and  from  the  solution  of  mucin  and  epi- 
thelium in  the  alkahne  fluid.  Viscous,  sizy,  stringy,  and 
tarry  (pitchy)  urine  is  found  in  pyelitis,  pyelo-nephritis,  or 
cystic  catarrh,  but  not  in  polyuria  owing  to  the  presence  of  the 
solvent  add. 

Odor  of  Urine.  This  is  somewhat  aromatic  in  horse  and 
ox,  disagreeable  in  the  dog,  and  repulsively  heavy  in  the 
cat.  With  polyuria  the  odor  is  less.  If  the  urine  has  been  re- 
tained and  fermented  it  is  ammoniacal,  if  there  are  ulcers  or 
tumors  it  is  foetid,  in  diabetes  it  smells  of  acetone,  after 
taking  turpentine  it  has  a  violet  odor,  and  after  phenic  add, 
camphor,  ether  and  other  drugs  it  is  variously  modified. 

Specific  Gravity  of  Urine  in  ratio  to  water  1000  : 


Horse, 

1020    to    1050 

(1040) 

Ox, 

1025 

1045 

(1030) 

Sheep;  Goat, 

1015 

1065 

(1040) 

Dog, 

1020 

1060 

( 1040) 

Pig, 

1005 

1015 

(loio) 

Cat, 

1020 

*     1040 

(1030) 

In  the  horse  the  urine  may  be  looi  to  loio  in  polyuria,  in 
chronic  interstitial  nephritis,  and  in  a  crisis  of  fever  attended  by 


198  Veterinary  Medicine. 

diuresis.  It  may  be  1050  to  1060  in  glycosuria.  Undissolved 
solids  that  are  merely  suspended  in  the  urine  do  not  affect  its 
density. 

A  rough  estimate  of  solids  may  be  made  by  multiplying  the 
last  two  figures  of  a  specfic  gravity  expressed  in  four  figures  by 
2.33.  The  result  approximates  to  the  number  of  grammes  of 
solids  in  1000  cc. 

Chemical  Reaction  of  Urine.  The  liquid  is  tested  by  litmus 
paper,  red  and  blue,  weakly  impregnated.  The  normal  reaction 
is  determined  by  the  food  :  the  urine  of  carnivora  and  sucking 
herbivora  is  acid  turning  blue  litmus  red  :  the  urine  of  vege- 
table feeders  is  alkaline  turning  reds  blue.  In  the  horse  the 
alkalinity  is  mainly  due  to  excess  of  lime  bicarbonate,  passing, 
with  standing,  into  lime  carbonate,  the  carbon  dioxide  being  de- 
rived from  organic  acids  (lactic,  malic,  citric,  etc.),  by  oxidation. 
The  hippurates  are  also  alkaline  in  reaction.  In  dogs  the  acidity 
is  due  to  lime  and  soda  phosphates,  sulphates,  urates  and  oxalates. 

Pathologically  we  find  the  urine  strongly  alkaline  from  the 
evolution  of  ammonia  from  urea,  in  fermentations  occurring  with 
prolonged  retention  in  the  bladder  or  in  cystitis.  The  urine 
is  acid  even  in  herbivora  in  all  fevers  in  which  appetite  is  lost  or 
seriously  impaired,  and  which  the  metabolism  is  excessive. 

Chemical  Changes  in  the  Urine  in  Disease.  Sodium 
Chloride,  is  present  in  large  amount  in  health  (horse  25  to  35 
grammes,  dog  0.25  to  5  grammes  daily)  is  diminished  in  fever, 
anaemia,  visceral  and  exudative  inflammations.  It  is  increased 
during  the  absorption  of  false  membranes  and  exudates.  It  is 
thrown  down  by  adding  solution  of  nitrate  of  silver,  the  curdy 
white  precipitate  being  insoluble  in  nitric  acid. 

Phosphates  of  lime,  soda,  potash  and,  scantily,  of  mag- 
nesia are  normally  present  (horse  0.08  to  0.60  gramme  phos- 
phoric acid  daily)  and  are  present  in  excess  in  digestive  disorders 
and  in  malnutrition  of  bones  (rachitis,  osteoporosis  and  rheuma- 
toid arthritis).  The  alkaline  phosphates  are  very  soluble  and 
never  precipitated.  Earthy  phosphates  dissolve  in  acid  urine, 
but  are  precipitated  from  alkaline.  To  a  little  of  the  urine  add  a 
few  drops  of  acetic  acid,  followed  by  a  few  drops  of  uranium 
acetate.  A  yellow  precipitate  of  uranium  and  ammonium  double 
phosphate  is  thrown  down. 


Physical  Properties  of  the    Urine,  199 

Indican  (CgH^NSO^)  is  formed  from  indol  which  passes  suc- 
cessively through  the  forms  of  indoxyle  and  indoxylid  potassio- 
sulphate.  This  is  normally  present  in  the  urine,  the  horse  ex- 
creting I  to  2  grammes  daily,  the  dog  o.  15  gramme.  It  is  present 
in  excess  in  intestinal  indigestions,  constituting  indicanuria.  It 
is  tested  by  adding  a  drop  of  muriatic  acid  and  one  of  a  solution 
of  chloride  of  lime  to  the  urine,  when  it  will  show  a  blue  ring, 
the  depth  of  which  indicates  the  relative  amount. 

Urea  (C  O  N,H^)  the  principal  waste  product  of  nitrogenous 
matter,  is  always  present  in  considerable  amount.  The  sound 
horse  may  eliminate  100  to  200  grammes  daily,  the  dog  5  to  180 
grammes.  It  is  present  in  excess  in  all  fevers  and  inflammations 
unless  urination  is  suspended  or  impaired,  in  cryptogamic  diuresis, 
in  mellituria,  uraemia,  nephritis'and  cystitis.  Test  :  The  addition 
to  a  filtered  solution  of  urine,  freed  from  phosphates,  of  solution 
of  acid  nitrate  of  mercury,  precipitates  it  as  nitrate  of  urea.  A 
simpler  test  is  to  add  to  a  drop  or  two  of  urine  on  a  glass  slide  a 
drop  of  nitric  acid  and  heat  gently.  The  nitrate  of  urea  is  pre- 
cipitated in  the  characteristic  rhombic  or  hexagonal  crystals  as 
seen  under  the  microscope.  Heat  urea  crystals  in  a  test  tube  : 
biuret  is  formed  and  ammonia  escapes.  Add  a  trace  of  a  copper 
sulphate  solution  and  a  few  drops  of  a  20  per  cent,  solution  of 
caustic  potash  :  a  rose-red  color  is  produced — the  biuret  reaction. 

Uric  Acid  (Cj  H^  N^  O,).  Traces  only  of  this  are  found  in  the 
normal  herbivorous  urine,  yet  it  is  more  abundant  when  on  a  full 
dry  grain  diet,  on  milk  (suckling)  or  on  animal  food.  The  dog 
kept  on  animal  food  has  a  large  amount. 

Pathologically  it  is  produced  in  the  dog  and  even  in  the 
horse  in  fever,  overwork  and  starvation,  the  animal  living  on  his 
own  tissues.  Interference  with  oxidation  in  the  lungs  seems  to 
produce  it  as  an  arrest  in  the  transformation  of  albuminoids  to 
urea.  The  neutral  urate  of  soda  remains  in  solution  :  the  acid 
urate  of  soda  is  precipitated.  Test :  To  the  urine  add  one-fourth 
its  volume  of  muriatic  acid  and  set  aside  for  24  hours  in  a  cool 
place.  On  the  bottom  and  sides  of  the  glass  and  on  the  surface 
of  the  liquid  will  be  found  the  yellowish  red  acicular  crystals  of 
uric  acid. 

Hippuric  Acid  (C,H,NO,)  is  normally  present  in  all  urine, 
but  is  especially  abundant  in  that  of  herbivora.     The  horse  elim- 


200  Veterinary  Medicine, 

inates  60  to  1 60  grammes  daily.  It  has  been  found  to  be  in- 
creased by  feeding  on  dandelion,  carrots,  clover,  asparagus, 
apples,  plums,  benzoic  acid,  oil  of  bitter  almonds,  toluol,  cinna- 
mic  or  kinic  acid.  It  is  absent  in  sucking  calves,  and  horses  fed 
on  grain  devoid  of  husk.  Pathologically  it  is  increased  in 
hyperthermia,  icterus,  some  liver  diseases  and  diseased  kidneys. 
Test  :  Precipitate  any  albumen  by  nitric  acid  and  boiling,  then 
add  hydrochloric  acid  which  precipitates  the  hippuric  acid  in  long 
needle-like  crystals.  Heated  in  a  small  glass  tube  it  forms  an  oily 
liquid,  and  heated  to  redness  gives  off  an  odor  of  hydrocyanic 
acid  (nitro-benzol)  and  carbon  is  left.  This  distinguishes  alike 
from  uric  acid  and  benzoic. 

Phenol  is  produced  by  intestinal  fermentation.  The  horse 
normally  excretes  about  3  grammes  daily.  Pathologically  it  ap- 
pears in  excess  in  indigestions,  abscesses,  softened  discharging 
tubercle,  pyaemia,  and  septicaemia.  Test  :  Dilute  solutions  of 
ferric  salts  give  a  blue  coloration. 

Creatinin,  a  product  of  metabolism  of  albuminoids,  is  found 
especially  in  the  urine  of  camivora  and  omnivora  in  health.  It  is 
pathologically  increased  when  oxidation  is  interfered  with,  as  in 
diseases  of  the  lungs.  Test :  Add  to  the  urine  a  very  dilute 
solution  of  sodium  nitro-prusside  and  then  drop  by  drop,  some 
solution  of  caustic  soda,  when  a  ruby  red  color  is  shown  and  dis- 
appears again  on  boiling.     Acetic  acid  changes  to  blue. 

Acetone  (C,H,0)  is  found  in  the  urine  of  healthy  omnivora 
and  camivora  and  increased  by  excess  of  nitrogenous  food. 
Pathologically  it  has  been  found  in  fevers  with  much  blood 
change,  in  inanition,  in  cancer,  in  indigestions,  and  auto-intoxi- 
cations. Test :  To  several  c  c.  of  urine  add  a  few  drops  of 
iodo-potassic  iodide  solution  and  caustic  potash  when  iodoform 
will  be  abundantly  precipitated  with  its  characteristic  color  and 
odor. 

Oxalic  Acid  (CjHjO^)  appears  to  be  secreted  in  small 
amount  by  healthy  kidneys  and  it  may  also  come  from  the 
splitting  up  of  uric  acid  after  secretion.  It  is  augmented  by 
feeding  agents  rich  in  oxalic  acid  (beets,  fresh  beans,  asparagus, 
tomatoes).  Pathologically  it  abounds  in  certain  indigestions, 
and  is  associated  with  lameness  and  emaciation.     Test :  Add 


Physical  Properties  of  the  Urine,  201 

lime  water  to  the  urine,  and  the  white  oxalate  of  lime  is  precipi- 
tated. 

AUantoin  (C^  H^  N^  O,)  is  found  in  the  urine  of  sucklings 
(calves)  during  the  first  few  weeks  of  life,  in  pregnancy  and 
when  on  a  meat  diet.  It  diminishes  with  the  increase  of  vege- 
table food. 

Xanthin  (CjH^N^O,)  is  found  in  urine  as  a  result  of  imperfect 
oxidation  of  nitrogenous  matters  especially,  which  would  other- 
wise pass  into  uric  or  hippuric  acid.  Its  immediate  antecedents 
in  such  transformation  are  guanin  and  hypoxanthin  or  sarkin. 
It  is  a  rare  constituent  of  urinary  calculus. 

Hypoxanthin  (C^H^N^O)  is  produced  from  fibrine  in  gastric 
and  pancreatic  digestion  and  in  putrefaction,  and  is  especially 
abundant  in  leucsemic  subjects. 

Cy anuria  Acid  (C,jH„N,0.)  occurs  in  dog's  urine. 

Leucin  (C.  H„  N  O,)  and  Tyrosin  (C,  H„  NO,)  are  products  of 
pancreatic  digestion  of  proteids,  and  the  former  occurs  normally  in 
the  spleen,  thymus,  thyroid,  liver,  salivary  glands,  and  urine. 
Both  are  present  in  large  amount,  in  the  urine,  in  acute  atrophy 
of  the  liver.  Test  for  leucin  :  Evaporate  carefully  to  dryness 
with  nitric  add  :  the  residue,  if  leucin,  will  be  almost  transparent 
and  turn  yellow  or  brown  on  the  addition  of  caustic  soda.  If  now 
heated  with  the  soda  it  forms  an  oily  drop.  Test  for  tyrosin  : 
treated  with  strong  sulphuric  acid,  gently  warmed  and  chloride 
of  iron  added,  it  gives  a  violet  color. 

Albumen  is  an  important  morbid  constituent  of  urine,  which 
appears  in  a  great  variety  of  diseases  (nephritis,  pneumonia, 
epilepsy,  anaemia,  leucaemia,  diabetes,  haematuria,  haemoglobi- 
nuria,  hydraemia,  infectious  lung  diseases,  cardiac  obstruction, 
venous  stasis  in  the  kidney,  dermatitis,  bums,  lesions  of  the 
crura  cerebri,  floor  of  the  fourth  ventricle,  spinal  cord,  or  renal 
vaso  motor  nerves).  It  also  occurs  after  violent  exertion,  in 
poisoning  by  strong  acid,  phosphorus,  arsenic,  lead,  mercury, 
opium  or  alcohol,  and  when  an  excess  of  albumen  is  injected  into 
the  blood.  All  forms  of  albumen  may  enter  the  urine,  but  the 
most  common  are  serum  albumen,  globulin  of  serum,  propeptone 
and  peptone.  A  simple  test  is  to  acidulate  the  urine  with  apetic 
acid  and  boil :  if  the  precipitate  does  not  dissolve  on  addition  of 
nitric  add,  it  is  albumen.  Sulphosalicylic  add  added  to  the  urine 
will  cause  a  predpitate  in  urine  containing  only  ^^rhrir  ^^  albumen. 


202  Veterinary  Medicine. 

Glucose  (CgH„Og)  is  often  normally  present  for  a  short 
period  in  small  amount  after  a  full  meal  of  farinaceous  material. 
It  is  permanently  present  in  excess  in  glycosuria,  which  may  re- 
sult, among  other  conditions,  from  diseased  liver,  punctured 
medulla,  suppression  of  milk  secretion  on  weaning  the  calf,  oil 
of  turpentine,  nitrobenzole,  nitrotoluol  or  amyle  nitrite.  Test : 
Add  yeast  to  the  urine  and  keep  at  15°  to  20°  C.  when  if  glucose 
is  present,  it  becomes  cloudy  and  gives  off  carbon  dioxide,  or  add 
a  little  caustic  potash  solution,  and  a  few  drops  of  cupric  sulphate 
solution  until  it  is  blue  :  then  heat  and  a  red  precipitate  of  cupre- 
ous oxide  is  thrown  down.  The  amount  gives  the  ratio  of  glu- 
cose. Uric  acid,  hypoxanthin  or  mucus  causes  brown  precipitate 
in  the  absence  of  glucose :  peptone,  creatin,  creatinine,  pepsin 
and  urinary  pigment  prevent  its  formation  though  glucose  be 
present. 

Bile  Salts  and  Pigments  are  present  in  excess  in  cases  of 
icterus,  where  these  characters  may  be  studied.     See  Icterus. 

Blood  and  Hsemoglobin  in  Urine.  In  a  variety  of  diseases 
(anthrax,  haematuria,  nephritis,  Texas  fever,  haemoglobinuria, 
etc.;  blood  or  blood  coloring  matter  escapes  in  the  urine.  When 
blood  escapes  one  finds  the  reddish  color,  and  under  the  micros- 
cope red  globules,  normal  or  crenated  (especially  in  alkaline 
urine),  free,  aggregated  in  masses,  in  small  clots,  or  embedded  in 
casts  of  the  uriniferous  tubes.  Under  the  spectroscope  the  spec- 
trum shows  two  dark  absorption  bands,  one  in  the  yellow  and  one 
in  the  green.  When  the  color  is  due  to  haemoglobin  the  urine 
shows  under  the  microscope  numerous  masses  of  amorphous 
brown  pigment,  and  the  spectrum  shows  one  dark  line  in  the  yel- 
low, and  three  others  less  deep,  (but  one  of  them  very  broad)  on 
the  limit  of  the  green  and  blue.  Urine  which  contains  the  ele- 
ments of  blood  is  usually  turbid  and  thick  or  glairy,  by  reason  of 
the  presence  of  salts,  albumen  and  fibrine.  There  may  also  be 
crystals  of  urinary  salts  (calculi),  fragments  of  broken  down 
tissue  (tumors)  or  the  ova  of  worms. 

Epithelium  in  Urine.  The  slight  cloud  seen  in  healthy 
urin^  contains  epithelial  cells.  The  source  of  these  may  be  often 
determined  under  the  microscope.  The  bladder  epithelium  are 
the  most  numerous,  the  largest,  and  are  squamous.  Those  from 
the  ureters  and  renad  pelvis  are  also  squamous,  but  neither  so 
large  nor  so  numerous.     The  epithelium  from   the  uriniferous 


Physical  Properties  of  the  Urine.  203 

tubules  are  polyhedral  with  large  nucleus,  or  columnar.  The  cells 
from  the  male  urethra  are  also  largely  columnar.  In  cases,  how- 
ever, in  which  these  cells  are  passed  in  large  amount  because  of 
catarrh  of  the  mucosa  all  alike  tend  to  assume  the  globular  form 
with  large  nucleus  so  that  their  true  source  cannot  be  certainly 
stated.  It  is  only  from  such  cells  as  have  become  detached  with- 
out change  of  form  that  the  seat  of  desquamation  can  be  deter- 
mined. If  an  excess  of  cells  approximating  to  the  kidney  type 
are  associated  with  albuminuria  and  cylindroid  casts  they  become 
diagnostically  significant.  Polygonal  cells  darkly  granular  with 
large  oval  nucleus  and  nucleolus  suggest  kidney  inflammation. 
If  the  granules  are  freely  soluble  in  ether  there  is  probably  fatty 
degeneration.  If  hard,  tough  and  glossy  they  suggest  (but 
don't  prove)  amyloid  degeneration. 

Pus  Cells  in  Urine.  Pus  cells,  with  multiple  nuclei  revealed 
by  adding  dilute  acetic  acid,  may  be  found  in  small  numbers  in 
apparently  healthy  urine.  When  present  in  large  numbers,  they 
usually  indicate  a  catarrhal  affection  of  the  mucosa,  and  especially 
pyelitis,  cystitis,  or  urethritis.  There  is  always  cloudiness,  excess 
of  mucin,  and  in  the  alkaline  herbivorous  urine,  the  liquid  may 
be  glairy  or  stringy. 

Casts  of  the  Uriniferous  Tubes.  These  usually  indicate 
the  existence  of  nephritis,  yet  they  may  be  present  in  small  num- 
bers in  the  urine  of  healthy  individuals  under  a  slight  toxic 
action  such  as  alcohol. 

Unorfranized  casts  of  urinary  salts  or  haematoidin  found  in 
sucklings  appear  to  have  no  pathological  significance.  Organized 
casts,  on  the  other  hand,  usually  imply  renal  troubles,  and 
especially  inflammation.  As  these  will  be  fully  described  under 
Bright' s  disease,  it  need  only  be  noted  here  that  they  may  be 
composed  in  great  part  of  red  globules,  leucocytes,  epithelium,  bac- 
teria, granules,  a  homogeneous  wax-like  matter,  fat  globules,  hya- 
line matter,  or  urinary  salts.  The  predominance  of  one  or  other 
of  these  determines  the  nature  of  the  cast. 

The  observations  of  Mayer,  Knoll,  Bovida,  Von  Jaksch  and 
others  seem  to  show  that  the  basis  substance  of  urinary  casts 
differs  from  all  our  familiar  proteids  and  must  be  considered  as  a 
distinct  nitrogenous  compound,  a  derivative  of  one  of  the  com- 
mon proteids. 


GENERAL  SYMPTOMS  OF  URINARY  DISEASE. 

External  symptoms,  arched  back,  stiff  gait,  straining,  tender  loins,  back- 
ing, turning,  dropping  under  weight,  urine  checked,  dribbled  ;  in  dogs  and 
cats,  palpation  of  kidney  ;  bladder,  urethra,  pains  in  different  animals.  In- 
ternal symptoms,  rectal  exploration,  vaginal,  urethral,  straining,  ureters, 
bladder,  calculi,  neoplasms,  prostate,  urethritis. 

External  Symptoms.  With  inflammatory  or  painful  affec- 
tions of  the  urinary  organs  the  animal  tends  to  roach  the  back 
or  loins,  tuck  up  the  abdomen,  move  the  hind  limbs  stiffly  and 
with  a  straddling  gait,  protract  and  withdraw  the  penis  which 
may  be  semi-erect,  retract  and  drop  the  testicles  alternately, 
and  stretch  himself  and  strain  to  pass  urine  without  success. 
Lying  down  and  rising  may  be  accomplished  with  marked 
effort  and  groaning.  The  loins  along  the  spines  or  beneath  the 
outer  ends  of  the  transverse  processes  may  prpve  tender  to  tapping 
or  pinching,  the  animal  drooping  to  excess.  Backing  or  turning 
in  a  narrow  circle  may  be  accomplished  awkwardly  and  stiffly 
though  usually  more  easily  than  with  lumbar  sprain.  The 
animal  drops  when  mounted  but  less  than  with  sprained  back. 
Urine  may  be  passed  in  excess  or  in  diminished  amount,  or  it  may 
be  entirely  suppressed.  It  may  be  abruptly  interrupted  when  in 
full  stream,  suggesting  calculus  or  polypus,  or  it  may  be  passed 
often  in  mere  driblets,  or  finally  it  may  ooze  away  constantly 
partly  lodging  in  the  sheath  and  partly  trickling  down  the  thighs. 

In  dogs  or  cats  with  flaccid  walls  of  the  abdomen  external 
manipulation  may  detect  in  the  kidneys,  differences  in  size,  posi- 
tion, and  tenderness  as  well  as  the  presence  of  tumors.  The  dis- 
tended bladder  also  may  be  distinctly  felt,  and  the  pyriform  area  of 
flatness  on  percussion  will  serve  to  map  out  its  size  and  outline. 

In  the  horse  the  urethra  is  superficial  and  easily  traced  over 
the  ischiatic  arch  and  for  some  distance  downward,  when  it  be- 
comes deeper  and  is  less  easily  felt.  In  the  bull  the  urethra  is 
deep  over  the  ischiatic  arch  but  becomes  more  superficial  lower 
down  and  can  be  easily  felt  at  the  sigmoid  flexure  and  below.  In 
sheep  and  dog  it  is  easily  followed  from  the  ischium  to  the  end  of 
the  penis. 

As  a  rule  the  penis  is  easily  drawn  from  its  sheath  in  the  horse 
204 


General  Symptoms  of  Urinary  Disease,,  205 

and  dog  ;  this  is  more  difficult  in  the  sheep  and  goat  and  still 
more  so  in  the  bull  and  boar.  In  the  small  animal  protrusion  is 
favored  by  setting  him  on  his  rump,  with  his  back  between  the 
operator's  legs,  and  pelvis  doubled  forward  toward  the 
sternum.  The  penis  of  the  bull  may  be  extended  in  presence  of 
a  cow  in  heat,  and  promptly  seized,  or  it  may  be  seized  through 
the  sheath  back  of  its  first  bulging  part  and  skillfully  worked  out. 
In  the  ruminant,  calculi  may  be  felt  at  the  sigmoid  curve,  and  in 
the  ram,  in  the  vermiform  appendix  at  the  free  end  of  the  penis. 

Internal  Exploration.  This  is  accomplished  in  the  larger 
animals  with  the  oiled  hand  in  the  rectum,  the  nails  having  been 
pared  short  and  even  to  avoid  injury  to  the  mucosa.  In  ponies 
and  yearlings  the  kidney  may  be  felt,  and  this  may  be  true  also 
of  mature  animals  of  larger  species  in  cases  of  hypertrophy  or 
floating  kidney.  The  ureters,  bladder  and  intrapelvic  urethra 
are  easily  felt  in  the  male.  The  empty  bladder  lies  on  the  an- 
terior border  of  the  pelvis  ;  when  full,  it  projects  forward  into  the 
abdomen  but  retains  its  pyriform  or,  in  the  very  young  animal, 
its  fusiform  shape.  In  the  female  the  sensation  is  somewhat 
modified  by  the  presence  on  its  upper  surface  of  the  uterus  divid- 
ing into  its  two  horns  anteriorly.  The  single  enlarged  horn  of 
pregnancy  is  especially  misleading. 

The  female  urethra,  cervix  and  bladder  may  be  explored 
through  the  vagina.  To  explore  the  cervix  vesicae  and  urethra 
the  fingers  are  slowly  drawn  back  from  the  bladder  along  the 
median  line  of  the  floor  of  the  vagina.  In  the  mare  the  cervix 
and  adjacent  portion  of  the  bladder  can  b^  further  explored-' with 
the  index  finger  introduced  through  the  opening  of  the  urethra 
in  the  floor  of  the  pelvis  and  at  the  junction  of  the  vagina  and 
vulva.  In  the  cow  the  urethra  is  too  small  to  be  readily  explored 
from  within,  and  the  orifice  is  still  further  guarded  by  the  two 
lateral  blind  canals  of  Gaertner,  into  which  the  unskilled  fingers 
more  readily  pass.  Success  only  attends  the  careful  search  for 
the  small  central  lower  orifice.  In  the  smaller  animals  the  finger 
only  can  be  introduced  into  vagina  or  rectum  and  the  urethra, 
cervix  and  bladder  only  can  be  felt.  The  result  of  such  explora- 
tion is  straining  even  in  healthy  conditions  but  which  becomes 
excessive  in  nephritis,  pyelitis,  renal,  uretral,  vesical  or  urethral 
calculus,  cystitis,  rectitis  or  enteritis. 


2o6  Veterinary  Medicine, 

The  ureters  are  tender  when  inflamed,  and  they  are  swollen  in 
calculous  obstruction  with  an  elastic  feeling  in  front  of  the  stone. 

The  bladder  is  very  sensitive  when  overdistended,  inflamed  or 
pendent  on  the  abdominal  floor,  or  when  the  seat  of  calculus. 
In  the  absence  of  any  liquid  contents  a  calculus  is  felt  as  a  hard 
solid  mass  firmly  clasped  by  the  contracted  vesical  walls.  If 
liquid  is  present  the  solid  hard  calculus  is  felt  movable  in  the 
fluid.  An  empty  contracted  bladder  is  firm  and  p5aiform. 
An  empty  flaccid  bladder,  resulting  from  rupture  or  exhaustion, 
is  flabby,  with  indefinite  form  and,  if  the  seat  of  a  lesion,  tender. 
It  varies  in  consistency  with  neoplasms  (papilloma,  sarcoma,  car- 
cinoma, or  epithelioma).  These  have  not  the  free  mobility  of 
the  calculus  floating  in  urine,  and  their  point  of  connection  with 
the  wall  may  often  be  made  out.  When  a  solid  body  is  felt,  or 
suspected  to  be  in  the  contracted  bladder,  an  injection  of  sterilized 
water  will  usually  facilitate  diagnosis,  and  a  differentiation  of 
calculus  and  neoplasm. 

Hypertrophy  of  the  prostate  is  felt  as  a  swelling  of  uneven 
outline  over  the  cervix  vesicae.  It  is  to  be  looked  for  especially 
in  old  dogs. 

Urethritis  is  indicated  by  swelling  and  tenderness  along  the 
median  line  of  the  pelvic  floor,  back  of  the  cervix.  With  a  cal- 
culus in  the  urethra  the  swelling  is  more  strictly  localized  and  the 
canal  in  front  of  it  may  be  full  and  elastic. 


HiEMATURIA. 


Symptoms  of  different  lesions  of  kidneys  and  constitutional  states,  of 
poisoning  by  irritant  plants,  common  on  moors  and  in  woods.  In  puerperal 
cow  fed  on  turnips  raised  on  mucky,  unreclaimed,  sour  lands.  Bacteria. 
Toxins.  Ansemia.  Poor  wintering.  Limed  new  soils.  Symptoms  :  in  plethoric, 
congested  mucosae,  vascular  tension,  hurried  breathing,  colics,  straining, 
red  urine  ;  in  vegetable  irritants,  depression,  weakness,  coldness,  trembling, 
stiffness  behind,scanty  red  or  black  urine,  diarrhoea,  constipation ;  in  ansemia, 
poverty,  debility,  red  urine,  pink  tinge  in  milk,  emaciation,  hide-bound, 
anorexia,  colics.  Chronic  or  intermittent.  Lesions  :  in  plethoric,  congested 
enlarged  kidney,  without  softening  ;  in  irritant  poisons,  congestion  also  of 
throat,  stomachji,  intestines,  liver  with  hsemorrhagic  extravasations ;  in 
ansemia,  kidneys  pale,  flaccid,  hydroaeniia,  liver  enlarged,  softened,  reddish 


Hematuria.  '207 

liquids  in  serous  cavities.  Treatment :  avoid  the  injurious  soils,  drain,  cul* 
tivate,  feed  products  of  such  soils  with  other  food,  oleaginous  or  saline  laxa- 
tives, antiferments,  tonics,  astringents,  flax  seed,  farinas. 

The  passage  of  blood  or  blood  elements  in  the  urine. 

Causes,  A  symptom  of  a  variety  of  diseases,  producing  lesions 
of  the  secreting  structures  of  the  kidneys ;  acute  congestion, 
tumors,  calculi,  parasitism.  Also  as  a  manifestation  of  diseases 
of  distant  organs — ^haemoglobinuria,  southern  cattle  fever,  an- 
thrax, poisoning  by  irritant  diuretics,  wounds  of  the  bladder, 
pelvic  fracture  with  injury  to  bladder  or  urethra,  cystitis  with 
varicose  cystic  veins,  etc. 

Among  the  irritant  plants  charged  with  producing  the  affection 
are  the  young  shoots  of  oak,  ash,  privet,  hornbean,  alder,  hazel, 
dogberry,  pine,  fir,  and  coniferae,  generally.  Also  ranunculus, 
hellebore,  colchicum,  mercuriales  annua,  asclepias  vincetoxi- 
cum,  broom,  etc.  The  disease  is  common  in  spring  in  cattle 
turned  out  too  early  to  get  good  pasturage  and  which,  it  is 
alleged,  take  to  eating  the  swelling  buds  and  young  shoots  of 
irritant  plants. 

The  disease  has  occurred  mostly  in  woods  and  wild  lands  and 
has  accordingly  been  vulgarly  named  the  wood  evil,  (maladie  de 
bois,  holzkrankheit),  and  moor  ill. 

In  England,  as  occurring  in  the  puerperal  cow,  Cuming,  of 
Ellon,  attributes  it  to  a  too  exclusive  diet  of  turnips.  His  analy- 
sis showed  that  turnips  contained  10%  sugar  and  i  to  i^% 
vegetable  albumen.  The  sugar  is  held  to  stimulate  unduly  the 
milk  secretion,  but  fails  to  supply  the  nitrogenous  materials  need- 
ful to  form  it  and  the  cow  is  speedily  rendered  anaemic,  with 
solution  of  the  blood  globules  or  of  the  haematin  and  its  excre- 
tion by  the  urine.  No  attempt  was  made  to  produce  haematuria 
by  an  exclusive  or  excessive  diet  of  sugar,  and  cows  fed  on 
turnips  grown  on  well  drained  lands  never  suffered  from  the 
disease. 

Williams  says  that  urine  in  such  cases  had  a  strong  odor  of 
rotten  turnips.  This  argues  not  an  anaemia  determined  by  sugar, 
but  rather  an  intestinal  fermentation,  perhaps  superinduced  by 
ferments  introduced  along  with  the  turnips.  Add  to  this  the 
notorious  fact  that  the  offending  turnips  are  usually  such  as  are 
grown  on  wild,  damp,  undrained,  swampy,  or  mucky  lands,  and 


2o8  Veterinary  Medicine, 

we  have  the  suggestion  of  a  bacteridian  poison,  or  a  toxic  product 
of  bacteria.  Williams  and  Reynal  practically  agree  on  the  point 
that  the  common  haematuria  is  the  result  of  anaemia.  It  has  long 
been  noticed  that  the  herds  which  suffer  from  the  affection  are 
those  which  have  come  out  of  the  winter  in  low  condition,  the 
victim  is  the  poor  man's  cow,  and  the  symptoms  are  most  likely 
to  appear  when  turned  into  the  fields  in  spring  before  the  pastures 
have  come  up.  The  anaemic  condition  of  the  carcasses  is  quoted 
in  support  of  this  view,  but  perhaps  without  making  sufficient 
account  of  the  extraordinary  destruction  of  blood  globules  during 
the  progress  of  the  malady. 

Pichon  and  Sinoir  see  in  the  liming  of  soils  and  the  production 
of  larger  crops,  a  cause  of  anaemia  in  the  rank  and  aqueous 
growth  of  the  meadows,  and  their  overstocking  in  order  to  eat 
them  down,  or  to  consume  their  products.  They  found  that  an 
abundant  artificial  feeding  was  the  most  efficacious  mode  of 
treatment. 

Reynal,  who  endorses  this  view,  tells  us  that  in  the  anaemic 
and  liquid  blood  the  globules  become  smaller  and  can  pass  more 
readily  through  the  walls  of  the  vessels.  But  this  is  exactly  the 
opposite  effect  from  what  we  see  when  the  blood  is  diluted  with 
water.  The  globules  in  such  a  case  are  distended  and  enlarged, 
and  may  finally  have  their  protoplasm  and  haematin  dissolved 
and  diffused  through  the  liquid.  If  the  blood  globules  are 
shrunken,  then  we  must  look  for  a  cause  very  different  from 
anaemia. 

Reynal  further  assures  us  that  plethora  is  a  common  cause  of 
haematuria  in  cattle.  *'  Under  the  prolonged  influence  of  a  very 
assimilable  diet,  the  blood  becomes  more  plastic,  circulates  with 
difficulty  in  the  capillaries,  and  may  even  rupture  them,  with  a 
resulting  capillary  renal  haemorrhage,  and  bloody  urine.'*  He 
further  intimates  that  this  occurs  especially  in  spring  after  the 
animals  have  been  turned  out  on  very  rich  pastures,  and  that  in 
Normandy  certain  pastures  of  unusual  richness  are  notorious  for 
producing  haematuria. 

Apart  from  the  fact  that  the  rich  grasses  of  spring  produce  at 
first  intestinal  congestion,  and  diarrhoea,  with  consequent  disorder 
of  the  liver  and  kidneys,  this  spring  affection  on  particular  pas- 
tures suggests  some  special  poison  in  the  pasture  as  the  unknown, 
cause  of  the  disease. 


Hematuria,  209 

In  all  forms  alike  of  this  affection  the  nature  of  the  soil  ap- 
pears to  have  a  preponderating  influence.  It  is  the  disease  of 
the  woods,  and  waste  lands,  of  damp  and  tmdrained  lands,  of 
dense  clays,  of  lands  underlaid  by  clay  or  hard  pan,  of  lands  rich 
in  vegetable  humus,  or  vegetable  moulds  the  decomposition  of 
which  has  been  hastened  by  the  application  of  quicklime. 

Pottier,  Salom6,  Wiener  and  Reynal  especially  testify  to  the 
prevalence  of  haematuria  on  soils  that. are  either  dense  and  im- 
permeable, or  that  have  a  subsoil  of  clay  or  hardpan. 

The  disease  has  not  been  traced  to  any  definite  microbe  nor 
toxin,  but  there  is  much  to  suggest  the  necessity  for  inquirj*^  in 
that  line.  The  special  susceptibility  of  animals  that  may  be 
plethoric  on  the  one  hand,  or  in  low  condition  on  the  other,  would 
be  entirely  in  keeping  with  such  a  view,  as  the  debility  or  de- 
rangement of  health  would  lay  the  system  open  to  attack. 

Symptoms,  In  the  plethoric  animal  there  are  congested  mu- 
cosae, full,  strong  pulse,  forcible  heartbeats,  full  veins,  accelerated 
breathing,  colicy  pains,  dullness,  straining  frequently  and  the  dis- 
charge of  thick,  red  or  bloody  urine. 

If  from  irritant  buds  and  shoots,  or  plants,  there  is  more  de- 
pression, weakness,  fever,  dry  skin,  staring  coat,  coldness  of  the 
surface,  tremblings,  stiffness  or  weakness  of  the  hind  limbs, 
diarrhoea,  followed  by  constipation,  frequent  straining  and  the 
passage  of  colored  urine  with  pain.  In  violent  cases  the  expul- 
sion of  bloody  urine  may  be  excessive,  and  the  cow  may  die  in  24 
hours.  From  irritant  plants  however  the  quantity  of  urine  is 
liable  to  be  small,  but  frequently  passed. 

As  occurring  irrespective  of  plethora  or  irritants  there  may  be 
at  first  only  poor  condition  and  debility  with  the  passage  of  blood. 
A  pink  tinge  may  show  on  the  froth  in  the  milk  pail,  and  a  red 
precipitate  on  its  bottom.  If  not  anaemic  at  the  outset  they  soon 
become  so,  and  the  pulse  which  was  at  first  bounding  becomes 
small  and  weak,  the  heart  palpitates,  the  red  mucosae  become 
pale.  The  subjects  become  tucked  up,  emaciated,  weak,  rough 
coated,  the  skin  adherent  to  the  bones,  and  the  appetite  and 
rumination  impaired  or  lost.     Sometimes  colics  are  present. 

In  the  milder  anaemic  forms  it  may  continue  for  months  before 
it  causes  death.     In  such  cases  it  may  prove  intermittent. 

Morbid  Anatomy,  In  the  haematuria  of  plethora  the  kidneys 
r4 


2IO  Veterinary  Medicine, 

are  large,  congested  and  of  a  dark  red,  but  preserve  their  normal 
consistency  and  texture. 

In  the  form  associated  with  ingestion  of  irritant  plants,  there  is 
congestion  of  the  pharynx,  stomachs,  and  intestines  with 
haemorrhage  c  spots,  congestion  of  the  liver,  violent  congestion  of 
the  kidneys  which  are  of  a  blackish  red  color,  and  enlarged  to 
perhaps  twice  the  normal  size,  with  haemorrhagic  exudations,  the 
convoluted  tubes  filled  with  fibrinous  exudate  and  blood  globules, 
the  pelvis  red  and  like  the  bladder  containing  some  reddish  urine. 
The  vesical  mucosa  may  be  black. 

In  anaemic  cases  the  kidneys  are  pale,  flaccid  and  colorless,  with 
a  reddish  liquid  in  the  pelvis  and  bladder.  The  vascular  system 
is  comparatively  empty,  and  the  blood,  thin  and  watery,  and  often 
coagulates  loosely  or  not  at  all.  As  noted  by  Herland  globules 
are  greatly  reduced  in  numbers  and  size,  and  often  crenated  or 
partially  broken  down.  Slight  serous  effusions  in  the  serous 
membranes  are  common.  The  liver  is  softened  and  enlarged,  the 
lacteals  have  reddish  contents,  and  the  ingesta  are  dark  colored. 

Treatment,  Preventive,  Avoid  haematuria  pastures  and  the 
fodder  grown  on  such  lands.  Drain  and  cultivate  such  soils. 
When  animals  must  feed  on  the  products  of  such  soils  supplement 
the  food  by  grain,  oil  cake,  cotton  seed  meal,  etc.  Avoid  stag- 
nant waters  draining  from  such  soils. 

Therapeutic  Treatment,  Give  oleaginous  or  saline  laxative  to 
clear  out  poisons  and  ferments  from  the  bowels  and  add  if 
necessary  an  antiferment  (salol,  salicylic  acid,  carbolic  acid,  tur- 
pentine oil,  chlorate  of  potash,  sulphites  or  hyposulphites),  even 
if  diarrhoea  is  present.  Follow  with  tonics  (copperas,  chloride 
of  iron)  and  stimulant  antiseptics  (ol.  terebinth,  potas.  chlorate) 
and  sound  food.  Flax  seed,  linseed  meal,  farinas.  Bitters  may  be 
added  (gentiAn^  quinine,  quassia).  As  a  calmative,  camphor  (2 
to  4  drs. )  2  or  3  times  a  day  has  proved  useful. 

In  case  of  nephritis  treat  as  for  that  affection. 

Weiner  lauds  empyreumatic  oil  and  oil  of  turpentine  with  cam- 
phor. 

In  chronic  cases,  nourishing  food  with  change  of  locality  and 
water  are  very  important. 

A  course  of  iron  tonics  should  wind  up  the  treatment. 


ACUTE  CONGESTION  OF  THE  KIDNEYS  IN  SOLIPEDS. 

Definition.  Causes :  bacteria,  toxins,  irritant  diuretics,  musty  oats  or 
fodder,  foul  water,  cantharides,  turpentine,  aqueous  grasses,  onions,  moult- 
ing, cold,  chills,  injuries  to  loins,  over  driving.  Lesions  :  kidney  enlarged, 
red,  black,  softened,  capsule  loose,  cut  surface  drops  blood,  brown,  sqftened 
necrosed  areas,  gorged  capillaries  of  glomeruli  and  convoluted  tubes, 
granular  or  fatty  changes  in  epithelium,  may  be  ruptures.  Symptoms: 
sudden  ;  weak  tender  loins,  slow  dragging  straddling  gait,  accelerated  pulse 
and  breathing,  anxious  countenance,  colics,  sweating,  urine  from  limpid  to 
black,  with  red  globules,  and  casts.  Prompt  recovery  or  nephritis.  Diag- 
nosis :  from  nephritis,  hsemoglobinuria,  laminitis,  indigestion.  Prevention  : 
Treatment :  bleeding,  laxatives,  diffusible  stimulant  diuretics,  bromides, 
diluents,  mucilaginous  agents,  fomentations,  sinapisms,  rectal  injections, 
clothing,  friction  to  the  skin,  restricted  laxative  diet. 

Definition .  Active  congestion  of  the  renal  capillaries,  especially 
of  those  of  the  glomeruli  and  convoluted  tubes,  with  colicy  pains, 
and  free  discharge  of  urine,  in  some  cases  bloodstained. 

Causes,  It  may  be  determined  by  local  irritation  caused  by  the 
passage  of  the  bacteria  and  toxins  of  infectious  diseases  such  as 
influenza  or  contagious  pneumonia.  In  the  same  way  irritant 
diuretics,  medicinal,  alimentary  and  toxic,  operate.  Diuretic 
balls  and  condition  powders  given  recklessly  by  stablemen  and 
grooms,  saltpeter,  resin,  oleo  resins,  turpentine,  rue,  savin,  col- 
chicum,  squill,  anemone  nemorosa,  adonis,  cynanchum  vincetox- 
icum  and  other  species  of  ascelepias,  hellebore,  mercurialis  annua 
and  bryony  are  examples.  The  young  shoots  of  the  coniferous 
plants,  fir,  balsam  fir,  pine,  white  and  yellow,  and  hemlock, 
are  at  times  injurious. 

In  the  same  way,  damp  moldy  oats  or  fodder  produce  renal 
congestion  and  excessive  polyuria,  also  corrupt,  stagnant  water 
and  that  of  marshes  which  often  contains  complex  toxic  products 
of  fermentation.  Water  of  ponds  in  which  cantharides  or  potato 
beetles  have  been  drowned,  is  dangerous.  The  cantharides,  eu- 
phorbium,  or  oil  of  turpentine  applied  too  extensively  to  the  skin 
as  a  counterirritant,  is  another  factor. 

Even  the  rich  aqueous  grasses  of  spring  succeeding  to  the  dry 
winter  diet,  stimulate  the  kidneys,  determining  an  active  conges- 
tion with  polyuria  and  in  bad  cases  haematuria.     In  many  such 

211 


212  Veterinary  Medicine, 

cases  there  are  superadded  the  acrid  diuretic  plants  already  re- 
ferred to.  In  Denmark  where  onions  are  g^own  on  a  large  scale, 
the  tops  fed  to  Unimals  have  produced*  renal  congestion.  ^ 

There  appears  to  be  an  extra  susceptibility  in  spring  when  the 
winter  coat  is  being  shed,  and  at  this  time  especially,  but  also  in- 
dependently of  this  and  at  other  seasons,  exposure  to  cold  and  the 
occurrence  of  chills  tend  to  induce  an  attack.  Exposure  to  cold 
storms  of  rain  or  sleet  when  perspiring  or  fatigued,  standing  tied 
out  of  doors  in  zero  weather  without  a  blanket,  wading  or  swim- 
ming deep  rivers  in  cold  weather  and  while  fatigued,  standing 
wet  and  unblanketed  in  a  cold  stable  when  returned  from  work, 
exposure  to  draughts  between  open  windows  or  doors,  the  con-' 
tinuous  falling  of  cold  rain  from  a  leaking  roof  on  the  loins,  the 
cold  of  a  damp  stable  newly  finished  in  brick  or  stone,  the  cold 
and  damp  of  an  undrained  floor  in  a  wet  retentive  soil,  all  have 
a  tendency  to  drive  the  blood  from  the  surface,  to  increase  the 
tension  of  the  blood  in  the  heart  and  internal  organs,  to  stimulate 
the  kidneys  to  extraordinary  secretory  activity,  and  at  the  same 
time  to  temporarily  debilitate  the  whole  system  and  lessen  the 
power  of  resistance  and  recuperation.  The  factor  is  especially 
potent  when  it  involves  the  nervous  interdependent  sympathy 
between  the  chilled  loins  or  abdomen  and  the  kidneys.  Sprains  and 
other  injuries  of  the  loins  have  long  been  charged  with  producing 
renal  congestion  and  inflammation,  and  even  Trasbot,  who  doubts 
the  reality  of  this,  acknowledges  that  the  already  diseased  kidneys 
are  seriously  injured  in  this  way.  Cadeac  and  Schmid  record 
cases  of  actual  rupture  of  the  horses*  kidney  from  violent  move- 
ment, and  other  cases  of  congestion  and  bloody  urine  have  been 
traced  to  kicks  on  the  loins,  falls,  sprains  and  the  carrying  of  un- 
duly heavy  loads.  The  overexertion  which  produces  albumin- 
uria, casts  and  sanguineous  transfusion  in  athletes  has  a  similar 
effect  on  the  overdriven  race  horse,  trotter  or  draught  horse. 

Lesions.  The  congested  kidney  is  enlarged,  sometimes  to  two 
or  three  times  its  natural  size,  softened,  and  red,  especially  in 
the  cortical  portion  which  may  be  so  dark  as  to  appear  cyanotic. 
*  The  capsule  is  also  the  seat  of  ramified  redness,  and  is  very 
loosely  adherent  to  the  cortex.  Beneath  it  may  be  considerable 
yellowish  exudate  especially  abundant  in  the  vicinity  of  the 
hilus.      On  section  the  cut  surface  is  very  bloody,  the  cortex 


Acute  Congestion  of  the  Kidneys  in  Soiifieds.  213 

literally  dropping  blood,  though  brownish  spots  may  appear  at 
intervals  representing  areas  of  necrosis,  which  under  pressure 
break  down  into  a  pulpy  debris.  Microscopically  the  glomeruli 
appear  hsemorrhagic,  the  capillary  vessels  being  gorged  to  ex* 
cess,  while  blood  globules  and  even  minute  blood  clots  are  found 
in  the  intervascular  spaces.  The  epithelium  covering  the  glom- 
eruli and  lining  the  convoluted  tubes  show  granular  or  fatty 
changes,  and  granular  matter  is  found  outside  the  vessels. 

The  congestion  is  less  in  the  medullary  portion  and  even  in 
the  convoluted  tubes  and  the  tubes  of  Henle,  though  these  may 
be  the  seat  both  of  hyperaemia  and  exudation. 

In  case  of  very  violent  congestion,  extensive  sanguineous  ex- 
travasation may  occur,  leading  even  to  rupture  of  the  capsule 
and  the  escape  of  blood  into  the  perirenal  adipose  tissue  or  into 
the  abominal  cavity.  Cases  of  this  kind  in  the  soliped  are  re- 
corded by  Caroni,  Cadeac,  Moussu,  Kitt,  Zundel,  MoUereau  and 
Porcher.  Averons  describes  in  the  Revue  Veterinaire  (1897)  a 
case  in  which  both  kidneys  were  surrounded  by  an  immense 
black  clot,  and  weighed  no  less  than  36  lbs,  Leblanc  records  a 
similar  case  affecting  the  one  kidney.  The  mass  measured  about 
10  inches  by  8. 

Symptoms,  These  are  liable  to  appear  suddenly,  often  while 
the  patient  is  at  work,  and  are  manifested  by  weakness  in  the 
loins,  slow  gait  or  sudden  stopping,  the  hind  limbs  are  held  in 
abduction,  and  advanced  with  apparent  stiflFness  and  pain.  There 
is  much  excitement  and  anxiety,  the  face  is  pinched  and  strained, 
the  respiration  accelerated,  the  pulse  hard,  tense  and  rapid,  and 
the  eyes  or  nose  may  be  turned  toward  the  flank  or  loins.  There 
may  be  colicy  pains,  with  uneasy  movements  of  the  tail  and  hind 
limbs,  pawing,  and  even  lying  down  and  rolling.  The  visible 
mucosae  are  strongly  injected  and  in  bad  cases  the  skin  may  be 
drenched  with  sweat.     There  is  at  first  little  or  no  hyperthermia. 

At  first  there  may  be  no  micturition  but  in  an  hour  or  more, 
urine  may  be  discharged  in  excess,  sometimes  as  much  as  25  quarts, 
and  of  a  low  specific  gravity  (looi  to  1005).  If  there  has  been 
no  blood  extravasation  it  is  usually  clear  and  limpid  but  with  ex- 
travasation it  may  be  of  all  shades  of  pink  or  red  to  black.  In 
the  latter  case  the  suffering  is  liable  to  be  acute  (Cadeac),  and 
contrary  to  the  condition  in  haemoglobinuria,  the  urine  contains 


214  Veterinary   Medicine. 

blood  globules  and  even  tubular  coagula  representing  the 
uriniferous  tubes  and  entangling  the  blood  cells.  This  is  com- 
plicated by  albuminuria. 

Course,  Duration,  The  congestion  is  short  lived.  It  speedily 
undergoes  resolution  with  the  passage  of  normal,  clear  urine,  and 
the  recovery  of  appetite  and  spirit,  or  it  becames  rapidly  aggra- 
vated, with  continuous  suffering  and  colic,  complete  loss  of  appe- 
tite, dullness,  constant  decubitus,  weakness,  debility,  small  or 
imperceptible  pulse,  palpitations,  darker  color  and  perhaps  com- 
plete suppression  of  urine,  and  stupor  or  other  nervous  disorder. 
Death  may  occur  on  the  fourth  to  the  sixth  day.  It  may  be 
delayed  by  a  partial  recovery  followed  by  a  relapse. 

Diagnosis.  Acute  renal  congestion  is  distinguished  from 
nephritis  by  the  suddenness  of  the  onset,  the  absence  of  fever 
and  the  comparative  absence  of  tenderness  of  the  loins,  and  of 
tubular  casts. 

From  hamoglolnnasfnia  it  is  distinguished  by  the  absence  of  the 
conditions  under  which  that  affection  appears: — the  previous 
heavy  work  and  full  rich  feeding,  the  day  or  more  of  complete 
rest  on  full  ration,  and  the  sudden  exercise  following.  The  hind 
parts  in  haemoglobinaemia  are  benumbed,  paretic,  or  paralytic 
and  not  unfrequently  rigid  and  swollen,  and  the  brownish  or 
reddish  urine  contains  haemoglobin  in  amorphous  particles,  and 
not  red  blood  globules  and  sanguineous  tubular  casts  as  in  renal 
congestion. 

From  laminitis  it  is  distinguished  by  the  absence  of  high  fever, 
by  the  absence  of  the  advance  of  the  fore  feet  resting  on  the 
heels,  of  the  heat  and  tenderness  of  the  feet,  by  the  ability  to 
bear  the  lifting  of  one  fore  foot,  or  the  tap  of  a  hammer  on  the 
toe,  by  the  lack  of  improvement  after  the  first  few  steps  as  is 
seen  in  laminitis,  and  by  the  absence  of  the  strong  pulsations 
in  the  digital  arteries. 

From  indigestion  it  is  distinguished  by  the  absence  of  the  his- 
tory which  leads  up  to  that  condition,  of  abdominal  tympany,  of 
rumbling,  of  impaction  and  of  frequent  attempts  to  defecate,  and 
by  the  presence  of  the  stiffness,  straddling,  and  the  blood  globules 
and  albumen  in  the  urine  of  low  density. 

Prevention,  This  must  be  sought  by  the  avoidance  of  all  the 
factors  of  causation : — ^autointoxication  in  contagious  diseases. 


Acute  Conj^estion  of  the  Kidneys  in  Solipeds.  215 

excessive  renal  irritation  from  the  injudicious  use  of  diuretics,  or 
the  accidental  ingestion  of  irritant  or  acrid  diuretic  plants  or 
waters,  or  musty  fodders,  or  the  sudden  change  to  the  succulent, 
watery,  first  vegetation  of  spring,  or  of  exposure  to  cold,  wet,  or 
damp,  in  all  their  forms,  or  of  direct  injury  to  the  back  or  loins 
by  blows,  shocks,  or  violent  exertions. 

Treatment,  Trasbot  and  Cadeac  strongly  recommend  vene- 
section, and  at  the  very  outset  in  specially  acute  cases  the  sud- 
den lessening  of  the  arterial  and  capillary  tension,  by  this  potent 
means,  may  furnish  the  opportunity  for  the  capillaries  of  the 
glomeruli  and  tubes  to  regain  their  normal  tone,  and  thus  contri- 
bute to  a  speedy  abortion  of  the  affection.  If  resorted  to  at  all  it 
should  be  made  in  a  full  stream  from  the  jugular,  so  as  to  secure 
the  fullest  and  most  prompt  result  with  the  least  possible  effusion 
of  blood. 

Much,  however,  must  depend  on  the  attendant  conditions.  In 
toxin  poisoning  following  on  an  infectious  fever,  the  already 
existing  debility  will  sufficiently  forbid  a  resort  to  the  lancet,  and 
we  must  seek  elimination  by  the  bowels,  the  skin  or  even  the  kid- 
neys. Antiseptics,  too,  are  in  order  if  there  appears  any  ground 
for  suspicion  of  the  action  of  infecting  agents.  Some  cases  will 
recover  promptly  under  diffusible,  stimulant  diuretics  such  as 
spirits  of  nitrous  ether,  which  by  stimulating  the  circulation  in 
other  organs  and  especially  the  skin,  appears  to  relieve  the  kidney 
and  solicit  normal  secretion.  But  most  veterinarians  dread  the 
stimulus  and  irritation  and  prefer  small  doses  of  refrigerant  diure- 
tics :  bicarbonate  of  soda  4  drs. ,  saltpeter  2  drs.  or  the  tartrates, 
citrates  or  acetates  of  the  alkaline  bases.  In  case  of  irritation  by 
acrid  diuretics,  but  especially  by  cantharides,  camphor  2  drs.,  has 
been  found  to  be  particularly  soothing,  and  next  to  this,  bromide 
of  camphor  or  bromide  of  potassium  i  to  2  drs.  may  be  resorted 
to.  Zundel  prescribes  acidulated  camphorated  drinks.  The  free 
use  of  mucilaginous  drinks,  such  as  boiled  flax  seed ;  and  the 
persistent  application  of  fomentations  or  wet  compresses  to  the 
loins  are  of  equal  value  in  soothing  irritation.  Sinapisms  may 
advantageously  follow  the  local  emollients. 

Laxatives  act  with  less  promptitude  than  diuretics,  but  on  the 
whole  constitute  a  safer  treatment ;  since  they  secure  elimination 
and  derivation  without  risk  of  irritation  to  the  kidneys.     The 


2i6  Veterinary  Medicine. 

oils :  castor  i  to  2  pints,  linseed  2  pints,  or  olive  2  pints,  are 
especially  to  be  recommended  in  this  respect,  but  T  Homme  advises 
manna,  and  calomel  may  also  be  used  as  a  substitute.  Injections 
of  warm  water  are  valuable  in  unloading  the  rectum  and  colon, 
soothing  the  kidneys  and  soliciting  peristalsis. 

A  restricted  amylaceous  diet  is  essential,  and  a  warm  stall  or 
abundant  clothing.  Grooming  or  active  rubbing  of  the  skin 
tends  to  active  derivation  and  often  materially  relieves.  The  case 
should  nol  be  abandoned  until  a  day  or  two  after  the  urine  has  re- 
turned to  the  normal,  and  for  some  time  special  care  should  be 
taken  of  the  diet,  stabling  and  work. 


ACUTE  CONGESTION  OF  THE  KIDNEYS  IN  CATTLE. 

Caaaes  :  infection,  toxins,  etc.,  irritant  diuretics,  chilU,  moulting,  swill. 
Lesions  :  cortical  kidney  congestion,  red  to  black,  softening,  friability  ; 
urine  limpid  to  red,  with  blood  globules,  albumen,  and  crystals.  Symptoms  : 
chill,  tender  loins,  colic,  straining,  recovery  in  four  days.  Diagnosis  :  from 
haenioglobinuria,  C3Stitis,  calculus.  Prevention :  diet,  etc.  Treatment: 
laxatives,  flax  seed,  wet  compresses,  bromides,  camphor,  disinfectants, 
bitters. 

Causes.  In  cattle  this  malady  is  largely  traceable  to  the  same 
causes  as  in  the  horse,  and  is  very  often  but  a  complication  of 
some  other  affection.  The  renal  congestion  of  infectious  diseases 
is  seen  in  the  advanced  stages  of  lung  plague,  in  anthrax,  in 
malignant  catarrh,  in  haemoglobinaemia,  and  implies  an  ac- 
cumulation of  irritant  toxins  in  the  system.  The  abuse  of 
diuretics,  the  ingestion  of  acrid  diuretic  plants,  including 
the  early  shoots  of  the  coniferae,  the  introduction  through 
any  channel  of  cantharides  or  potato  beetles,  the  drinking  of 
stagnant  water  charged  with  deleterious  fermentation  pro- 
ducts, the  consumption  of  musty  or  spoiled  fodder,  and  the  sud- 
den change  to  the  succulent  grasses  of  spring,  operate  as  in  the 
horse.  So  it  is  with  cutaneous  chills,  cold  stone  floors,  cold  wet 
storms,  draughts  and  dropping  from  a  leaky  roof.  The  shed- 
ding of  the  coat  in  spring  is  an  undoubted  predisposing  cause. 

Cattle  in  the  swill  stables  of  breweries  and  distilleries  are  the 
subjects  of  a  constant  renal  congestion  and  polyuria,  which, 
however,  does  not  prevent   rapid   fattening.     This  diet,    how- 


Acute  Congestion  of  the  Kidneys  in  Cattle,  217 

ever,  unfits  the  animal  for  a  future  vigorous  life,  and  any 
concurrent  injurious  influence  may  easily  bring  on  active  kid- 
ney disease. 

Lesions,  There  is  redness  and  swelling  of  the  kidney,  it  may 
be  to  two  or  three  times  its  normal  size,  the  enlargment  being 
especially  referable  to  the  cortical  portion,  which  may  be  mottled 
in  diflFerent  shades  of  red  up  to  black  extravasations.  The  lack 
of  firmness  in  its  connection  with  its  sheath,  and  the  softening 
and  friability  of  the  parenchyma  resemble  the  same  conditions  in 
the  horse.  The  urine  may  be  clear  or  more  or  less  tinged  with 
blood,  and  contains  blood  globules,  albumen,  and  crystals  of  car- 
bonate of  lime  and  urate  of  ammonia,  which  seem  to  indicate  the 
presence  of  a  bacterial  ferment. 

Symptoms.  The  patient  usually  shows  some  indication  of  chill, 
with  staring  coat  and  arched  back,  which  is  very  sensitive  to 
pinching.  There  is  impairment  of  rumination  and  appetite,  de- 
crease of  milk  in  dairy  cows,  uneasy  movements  of  the  hind 
limbs  and  tail,  frequent  straining  to  urinate,  and  the  passage 
of  urine  often  in  small  amount  and  sometimes  of  a  pink  or 
reddish  tinge.  In  bad  cases  this  may  become  deep  red,  or 
black,  and  the  pulse  becomes  weak,  with  psUpitations,  marked 
muscular  weakness  and  a  tendency  to  lie  down  most  of  the 
time. 

With  early  improvement  recovery  may  be  complete  in  from 
four  to  six  days.  In  the  more  severe  and  fatal  cases  death 
may  occur  as  early  as  the  sixth  day.  Unless  under  the  in- 
fluence of  violent  irritants  or  a  persistence  of  the  original  poison 
the  prognosis  is  favorable. 

Diagnosis,  It  is  especially  important  to  distinguish  this  from 
haemoglobinaemia,  which  shows  an  uniform  red  or  brown 
discoloration  of  the  urine  and  an  entire  absence  of  blood 
globules  as  such.  In  congestion  the  reddish  material  tends  to 
precipitate  and  is  found  to  consist  largely  of  blood  globules.  It 
is  further  associated  with  albuminuria. 

Haemorrhagic  cystitis  and  cystic  calculi  are  both  chronic 
affections,  and  identified  on  rectal  exploration  by  the  tenderness 
of  the  bladder  and  the  presence  of  the  stone. 

Prevention  consists  in  the  avoidance  of  the  various  causative 
factors,  and  especially  those  that  find  access  among  alimentary 


21 8  Veterinary  Medicine, 

matters.  Cattle  turned  out  in  early  spring  should  be  fed 
before  going  and  should  be  returned  from  the  pasture  in  an 
hour  or  two.  This  repeated  day  by  day,  allows  the  digestive 
and  urinary  organs  to  accommodate  themselves  to  the  fresh 
spring  grass  and  to  any  vegetation  to  which  the  animals  have 
not  been  accustomed.  Chill,  draughts,  injuries  and  other  dis- 
turbing conditions  must  be  guarded  against. 

Treatment.  Bleeding  is  strongly  recommended  by  Cruzel  and 
Cadeac.  In  Germany,  England  and  America  derivation  toward 
the  digestive  organs  is  more  generally  relied  on.  La,xatives 
should  be,  as  in  the  horse,  oleaginous  (castor,  olive,  linseed)  or 
manna,  rather  than  agents  that  may  perchance  act  on  the  kid- 
neys. Free  purgation  should  be  secured.  Flaxseed  tea,  and 
wet  compresses  over  the  loins  are  valuable  adjuncts,  and  anodyne 
agents  like  camphor,  bromide  of  camphor,  or  other  bromides 
may  be  added,  and  when  there  is  any  suspicion  of  infection,  salicy- 
lates, or  iodide  of  potassium  may  be  employed.  Finally  a 
course  of  bitters  (salicin,  quinine,  nux.)  may  be  employed  to  re- 
store tone  and  iron  carbonate  with  sodium  carbonate  as  a  recon- 
structive tonic.  The  diet  must  be  changed  to  wholesome  food» 
but  not  too  stimulating,  and  the  animal  kept  quiet. 


ACUTE  CONGESTION  OF  THE   KIDNEYS  IN  SHEEP 

AND  GOAT. 

Causes :  irritant  food.  Lesions  :  Symptoms  :  separates  from  its  fellows, 
arched  back,  stiff  straddling  gait,straining,  muscular  weakness,  recumbency, 
urine  red,  with  blood  globules  and  albumen.  Prevention  :  care  in  feeding 
and  watering,  change  of  pasture  and  treatment  as  in  the  ox. 

Causes,  As  in  cattle,  the  smaller  ruminants  appear  to  suffer 
especially  from  an  alimentary  renal  congestion,  showing  itself 
mainly  in  animals  that  are  unaccustomed  to  the  particular 
toxic  aliment.  Thus,  Comevin  finds  that  the  Pyrennean  sheep 
thrives  on  the  leaves  of  the  Quercus  tosa,  while  Southdown  sheep 
taking  them  in  any  considerable  quantity  perish  of  renal  congestion 
or  nephritis.  Similarly  Weith  fed  four  sheep  on  cynauchum 
vincetoxicum  and  developed  renal  congestion  in  the  course  of 


Acute  Congestion  of  the  Kidneys  in  Swine.  219 

three  days.  Other  causes  doubtless  contribute  in  individual 
cases  but  have  not  been  specially  traced  to  their  effects. 

Lesions  are  in  the  main  the  same  as  in  cattle,  the  kidneys 
being  bluish  red,  soft,  flaccid  and  friable. 

Symptoms,  The  sheep  lags  behind  the  flock,  frequently  lies 
down  and  rises,  strains  to  urinate,  and  passes  often  considerable 
quantities.  The  back  is  arched,  the  loins  tender,  the  walk  stiff 
and  straddling,  the  pulse  small  and  weak.  If  the  disease  ad- 
vances, there  come  on  extreme  muscular  weakness,  a  disposition 
to  lie,  an  uncertain,  gait,  with  frequent  stumbling,  dullness, 
stupor,  and  it  may  be  coma.  The  urine  is  usually  tinged  with 
blood  or  of  a  deep  red  or  black,  and  contains  well-formed  blood 
globules  and  more  or  less  albumen. 

Prevention  and  treatment  should  proceed  on  the  same  lines  as 
in  the  ox,  but  in  dealing  with  a  large  herd  it  becomes  diffcult  to 
treat  each  separate  case  with  special  care.  The  avoidance  of 
sudden  change  of  food  as  in  turning  out  in  spring,  the  feeding  of 
grain  before  turning  out,  the  return  to  the  fold  after  a  short 
freedom,  and  the  gradual  transition  to  the  new  food  are  im- 
portant. When  the  disease  has  developed,  an  entire  change  of 
pasture  or  food,  the  use  of  roots,  ensilage,  or  grain,  or  of  freshly 
cut  meadow  grass,  and  an  oleaginous' laxative  (castor  oil  2  to  3 
ozs. )  are  indicated.  Oilcake  or  flaxseed  meal  will  often  prove 
a  most  valuable  article.  Beyond  this  the  same  agents  would  be 
indicated  as  for  the  ox. 


ACUTE  CONGESTION  OF  THE  KIDNEYS  IN  SWINE. 

Causes  :  infection,  toxins,  fermented  food,  traumas,  crowding,  cold. 
Symptoms  :  stiff  loins  and  quarters,  frequent  micturition,  urine  limpid  or 
red.    Treatment. 

Renal  congestion  in  pigs  has  been  seen  mainly  as  the  result  of 
toxin  poisoning  in  swine  erysipelas,  hog  cholera  or  caseous  pneu- 
monia. It  is  also  liable  to  occur  from  putrid  or  overfermented 
food,  and  in  fat,  heavy  animals  from  injuries  sustained  in  ship- 
ping by  rail  by  trampling  on  or  squeezing  each  other.  KLicks 
and  other  injuries  may  at  times  contribute  to    its   occurrence. 


220  Veterinary  Medicine, 

Exposure  to  cold  storms,  to  which  swine  are  especially  sensitive, 
a  wet,  cold  bed,  or  a  leaky  roof,  are  additional  causes. 

The  Symptoms  are  more  or  less  stiffness  of  the  loins  and  hind 
parts,  frequent  urination,  the  secretion  being  often  passed  in  ex- 
cess, and  though  at  times  clear  yet  at  others  pink  and  bloody  and 
precipitating  blood  clots  or  at  least  containing  blood  globules. 

Treatment  is  mainly  prophylatic.  If  therapeutic  measures  are 
desirable  for  valuable  animals,  they  should  follow  the  same  lines 
as  for  sheep  :  rest,  fomentation,  aqueous  food,  anodynes,  weak 
alkaline  diuretics,  laxatives,  and  balsams. 


CONGESTION  OF  THE  KIDNEYS  IN  CARNi;VORA. 

Causes  :  acrid  diuretics,  loss  of  kidney,  catheterization,  dermatitis,  bums, 
traumas,  overexertion.  Lesions :  enlarged,  blood- gorged  kidney,  red  or 
black,  petechiated.  Symptoms :  stiff,  arched,  tender  loins,  tardy,  dragging 
of  hind  limbs,  urine  passed  often,  clear  to  bloody,  albuminous,  anorexia, 
nausea,  vomiting,  diarrhcea,  dullness,  stupor.  Treatment :  stop  cause,  give 
emetic,  laxative,  in  surgical  cases  antiseptic,  for  cantharides,  camphor, 
bromides,  vegetable  food.     Warm  clothing  or  building. 

Causes.  This  comes  most  commonly  from  the  ingestion  of  acrid 
or  diuretic  agents,  saltpeter,  turpentine  oil,  cantharides  and, 
according  to  Cadeac,  various  essential  oils  including  oil  of  mus- 
tard. It  takes  place  in  the  remaining  kidney  after  the  one  has 
been  extirpated,  or  had  its  functions  abolished  by  disease  or 
uretral  obstruction.  Again,  surgical  operations  on  the  urinary 
organs,  eten  the  simple  passing  of  a  catheter,  will  cause  sym- 
pathetic renal  congestion.  Extensive  acute  dermatitis,  and  bums 
of  the  skin  may  have  a  similar  sequence. 

Falls,  kicks,  blows,  or  crushing  beneath  a  wheel  or  otherwise 
are  additional  causes. 

Finally  violent  overexertion  as  in  coursing,  causes  congestion 
with  albuminuria,  and  blood  globules  and  even  casts  in  the  urine. 
This  is  common  to  the  human  athlete  (who  undergoes  a  violent 
and  continued  over  exertion),  also  in  race  and  draught  horses,  and 
dogs. 

Lesions.  When  congestion  is  produced  experimentally  by  can- 
tharides the  kidneys  are  found  to  be  enlarged  and  the  cortex 
gorged  with  blood  so  that  it  has  a  deep  red  or  blackish  port  wine 


.  Nephritis.  221 

hue,  with  here  and  there  spots  of  ecclyraosis.  The  veins  capil- 
laries and  glomeruli  are  especially  congested,  and  the  epithelial 
cells  of  the  convoluted  tubes  have  become  laterally  distended,  so 
that  they  approximate  to  a  globular  form.  A  loose  coagulum 
containing  blood  globules  may  be  found  in  the  capsule  of  the 
glomerulus  and  in  the  convoluted  tubes. 

Symptoms,  These  are  arching  and  stiffness  of  the  loins,  a 
tardy,  dragging  movement  of  the  hind  limbs  and  tenderness  of 
the  loins.  The  urine  may  be  scanty  or  in  excess,  and  tends  to 
be  passed  frequently,  in  small  quantities  and  with  evidence  of 
pain.  It  may  be  clear,  pinkish  or  bloody,  and  shows  albumen 
and  frequently  casts,  and  blood  globules  or  small  clots.  There 
is  some  impairment  of  appetite,  and,  in  severe  cases,  nausea  and 
vomiting,  with,  it  may  be,  diarrhoea,  nervous  depression,  dull- 
ness and  stupor.  When  due  to  poison  or  other  transient  cause 
the  symptoms  improve  when  this  factor  has  been  stopped. 

Treatment,  When  due  to  poison  taken  by  the  stomach  this 
must  be  stopped,  and  the  stomach  and  bowels  evacuated  by 
an  emetic  (ipecacuan)  and  laxative  (sodium  sulphate).  Appro- 
priate treatment  must  be  made  in  case  of  burns  or  skin  eruptions. 
When  surgical  cases  are  due  to  infection  rather  than  simple 
shock  or  sympathetic  irritation,  antiseptic  injections  of  the 
bladder  are  indicated.  In  all  cases  alike  a  warm  bath  is  an  im- 
portant adjunct.  When  irritation  is  due  to  cantharides,  it  may 
be  calmed  by  camphor,  2  grains  every  three  or  four  hours. 
Other  anodynes  may  be  given  as  required.  Rest  is  essential  and, 
as  appetite  is  recovered,  a  moderate  amount  of  amylaceous  pud- 
dings.    A  warm  building  or  comfortable  clothing  is  desirable. 


NEPHRITIS. 


The  renal  iuflammations  have  not  been  fully  investigated  in  the 
domestic  animals,  and  even  in  man,  the  pathology  of  several  of 
the  forms  is  still  enveloped  in  some  measure  of  doubt.  In  man 
the  following  conditions  have  been  noted  : 

1st.  Acute  parenchymatous  nephritis  with  enlarged  kidney  and 
degenerated  tubules. 


222  Veterinary  Medicine, 

2d.  Chronic  parenchymatous  nephritis  with  enlarged  kidney  and 
degenerated  tubules. 

3d.  Acute  diffuse  {^desquamative ^  interstitial)  nephritis  with  en- 
larged kidney  and  glomeruli,  tubules  and  connective  tissue  degen- 
erated. 

4th,   Chronic  diffuse  (^desquamative,  interstitial)  nephritis, 

5th.  Suppurative  nephritis  and  pyelo-nephritis,  infection  may 
be  from  injury. 

6th.  Peri-nephritis  :  infection  of  connective  tissue  with  adjacent 
disease. 

In  domestic  animals  the  following  distinctions  have  been  made  : 

I  St.  Acute  nephritis, 

2d.   Chronic  nephritis. 

3d.  Purulent  nephritis  and pyelo-nephritis, 

4th.  Peri-nephritis. 


ACUTE  NEPHRITIS.     ACUTE  BRIGHT'S  DISEASE. 

Animals  affected.  Causes  :  hyperaemia,  traumas,  cold,  chill,  fever,  bac- 
teria, toxins,  overfeeding,  nitrogenous  food,  ra«¥  potatoes,  xanthin  products, 
acrid  diuretics,  diuretic  insects,  suppression  of  micturition,  skin  lesions, 
bums,  embolism,  calculus.  Symptoms  :  colic,  trembling,  rigor,  arched, 
stiff,  tender  loins,  stiffness  in  quarters,  drags  hind  legs,  urination  frequent, 
movements  of  penis  and  testicle,  costiveness,  grinding  teeth,  anorexia, 
vomiting  (in  dogs,  cats  and  pigs),  fever,  dropsies,  ursemic  convulsions^ 
urine  scanty,  high  colored,  red  or  bloody,  thin,  cloudy  or  turbid,  albumi- 
nous, purulent,  oxalates,  urates,  hippurates,  hsematoidin,  epithelium, 
mucus,  casts.  Prognosis :  resolution  in  three  days,  or  ursemia,  suppuration, 
degenerations.  Lesions :  kidney  enlarged,  softened,  friable,  red,  yellow, 
black,  purulent,  glomerulitis,  tubular  hephritis,  interstitial  nephritis.  Treat- 
ment :  rest,  warm  building,  warm  clothing,  green  or  sloppy,  amylaceous 
food,  bleeding,  cupping,  skin  friction,  fomentations,  warm  bath,  hot  air 
bath,  sinapisms,  anodynes,  laxatives,  diaphoretics,  heart  tonics,  alkaline 
diuretics,  paracentesis,  bitters,  iron,  phosphates,  hydrogen  peroxide,  cubebs, 
etc. 

Genera  affected.  This  has  been  seen  in  horse,  ox,  dog,  sheep 
and  pig. 

Causes.  It  is  ascribed  to  the  most  varied  causes,  such  as : 
hyperaemia,  blows  and  injuries  on  the  back  and  loins,  sprains  of 


Acute  Nephritis.     Acute  BrighVs  Disease,  223 

the  loins,  abrupt  wheeling  when  in  galop,  exposure  to  cold  winds, 
and  storms,  especially  when  perspiring  and  fatigued,  sudden  sup- 
pression of  perspiration,  extreme  terror,  bacterial  infection  and 
infection  by  toxins  (in  septicaemia,  pyaemia,  influenza,  contagious 
pneumonia,  uterine  sepsis,  omphalitis,  infectious  angina  (Fried- 
berger),  bronchitis  (Siedamgrotzky),  glanders,  tuberculosis. 
Among  dietary  causes  are  named  :  a  rich  nitrogenous  food 
(grains,  beans,  peag,  vetches,  cotton  seed,  clover),  raw  potatoes 
in  excess,  cotton  seed  meal,  agents  that  increase  the  nitrogenous 
and  xanthin  bodies  in  the  urine. 

Dr.  Alfred  C.  Croftan,  in  his  experiments  with  xanthin 
bodies  on  rabbits,  found  that  xanthin  and  hypoxanthin  pro- 
duced great  increase  of  arterial  pressure,  atheromatous  changes 
in  the  vessel  walls  consisting  in  thickening  of  the  intima,  with 
small  celled  infiltration  and  necrotic  changes  in  different  areas  of 
the  vessel  walls.  This  in  the  kidney  produces  the  primary  inter- 
stitial form  of  nephritis  known  as  gouty  kidney  and  associated 
with  retention  of  uric  acid  and  other  xanthin  bodies.  The 
accompanying  cardiac  hypertrophy,  so  common  with  such  kid- 
neys, he  attributes  to  the  increased  intravascular  pressure. 

Irritant  vegetables  that  are  resinous  or  diuretic,  and  irritant 
diuretic  insects  are  incriminated  (cantharides,  caterpillars  in 
grass,  or  on  plants,  etc.,  lice  on  cabbages  particularly, — Cruzel, 
Neubert).  Irritant  drugs  that  are  eliminated  by  the  kidneys 
have  been  equally  charged  (tar,  carbolic  acid,  iodoform,  chlorate 
of  potash,  nitrate  of  potash,  phosphorus,  arsenic,  lead,  mercury). 
Compulsory  suppression  of  micturition  is  undoubtedly  injurious 
in  house  dogs  shut  up,  mares  kept  long  in  harness,  or  horse  on 
railway  car,  above  all  if  this  follows  a  diuretic  or  drinking 
abundantly.  In  such  cases  it  is  altogether  probable  that  bacteria 
already  exist  in  the  blood  or  kidneys  and  take  occasion  to  attack 
the  tissues  weakened  by  the  overdistension  or  other  inimical 
cause.  This  is  all  the  more  probable  seeing  that  the  kidneys  are 
a  favorite  channel  for  the  elimination  of  bacteria  present  in  the 
system.  It  should  be  noted  that  nephritis  is  liable  to  supervene 
on  extensive  skin  bums,  chronic  dermatitis  and  other  skin 
diseases.  vSome  cases  are  traceable  to  embolism,  the  clots  coming 
from  the  lungs,  heart  or  arteries,  in  others  the  irritation  is  due  to 
calculi  in  the  renal  pelvis  or  tubules,  and  their  attendant  bacteria. 


224  Veterinary  Medicine, 

These  are  especially  common  in  cattle  that  are  winter  fed  on  dry- 
food.  Again,  the  infection  may  have  travelled  forward  through 
the  ureters  from  a  pre-existing  infective  cystitis. 

Symptoms,  There  may  be  obscure  or  intense  colic  ;  trembling 
or  rigor  may  occur,  yet  is  often  omitted  or  unobserved  ;  the  loins 
are  arched  ;  the  hind  feet  are  advanced  under  the  belly,  or  there 
is  frequent  shifting  of  the  weight  from  one  foot  to  the  other;  the 
walk  shows  stiffness  of  the  back  and  hind  limbs  which  appear  to 
straddle  or  drag  behind  ;  urination  is  frequent  in  small  amount, 
or  there  are  frequent  inffectual  attempts  to  urinate  ;  the  patient 
is  indisposed  to  lie  down,  and  if  he  does  so  it  is  carefully,  with 
difficulty  and  groaning  ;  the  testicles  are  drawn  up  and  dropped 
alternately,  the  penis  is  often  protruded  from  and  retracted 
within  its  sheath,  the  loins  are  sensitive  to  pinching,  percussion^ 
or  electric  current  ;  when  mounted  the  animal  drops  under  the 
weight ;  he  carries  the  head  low  and  refuses  to  go  fast.  In  bad 
cases  there  is  constipation,  grinding  of  teeth,  anorexia,  and  in 
dogs,  vomiting.  Temperature  may  be  normal  or  there  may  be 
considerable  fever.  Dogs  may  lie  curled  up,  with  occasional 
tremors.  Dropsical  effusions  are  frequent  in  the  form  of  anasarca 
under  the  chest  or  abdomen,  or  beneath  the  lower  jaw,  or  as 
stocking  of  the  limbs,  or  the  effusion  may  occur  into  an  internal 
serous  cavity.  Convulsions  may  occur  from  brain  poisoning  by 
urea  or  other  retained  urinary  product. 

In. the  slighter  forms  the  severe  symptoms  may  be  absent,  and 
the  condition  of  the  urine  must  be  investigated  as  affording  the 
most  constant  and  characteristic  phenomena. 

The  urine  is  usually  scanty,  high  colored,  of  a  high  specific 
gravity  and  is  passed  often  with  pain  and  groaning.  At  the  out- 
set of  an  acute  attack  it  may  be  bloody ;  later  it  may  be  only 
cloudy  or  turbid  from  the  excess  of  epithelial  and  pus  cells,, 
leucocytes,  salts  and  albumen.  Early  in  the  disease  the  casts 
may  contain  red  blood  cells,  and  renal  epithelium,  later  leucocytes, 
nuclei,  granules,  pus  cells,  crystals  and  other  matters.  Albumen 
is  usually  abundant  as  demonstrated  by  boiling  and  nitric  acid. 

Soda  carbonate  crystals ^  rhomboid,  rosette-shaped  or  spherical 
and  effervescing  with  acetic  acid,  abundant  in  normal  herbivorous 
urine,  may  be  greatly  reduced  or  absent  in  nephritis. 

Soda  oxalate  crystals,  tetrahedral  and  insoluble  in  acetic 


Acute  Nephritis,     Acute  Bright* s  Disease.  225 

acid,  and  normal  in  herbivora  and  camivora,  are  increased  if  the 
urine  is  acid  as  in  severe  nephritis,  but  also  in  rheumatism,  te- 
tanus, septicaemia,  angina,  heaves,  and  other  affections  with  de- 
fective aeration  of  the  blood. 

Ammonio-magnesian  phosphate  crystals,  rhomboid  but' 
insoluble  in  acetic  acid,  are  found  in  alkaline  (ammoniacal )  or  neu- 
tral urine,  and  appear  to  be  often  due  to  intestinal  fermentations. 

Cystine  crystals,  flat  hexagonal  plates,  precipitated  in  healthy 
urine,  but  dissolved  by  ammonia  are  absent  in  retained  and  fer- 
mented specimens. 

Uric  acid  crystals,  rhomboids  and  plaques,  brick  red,  and 
normal  in  the  urine  of  carnivora  and  flesh-fed  omnivora,  may  be 
present  in  herbivora  not  only  in  acute  nephritis,  but  in  other  ex- 
tensive inflammations  attended  with  anorexia  and  the  consump- 
tion of  the  animal  tissues. 

Hippuric  acid  crystals,  right  rhombic  prisms  and  their  de- 
rivatives, and  insoluble  in  hydrochloric  acid  or  ether,  are  greatly 
increased  in  all  febrile  diseases  in  herbivora,  nephritis  included. 

Haematoidin  crystals,  fine  needles  or  bundles  of  the  same, 
yellowish  red,  are  found  in  nephritis,  haematuria,  heaves,  etc. 

Epithelium,  if  columnar,  points  to  disease  of  the  kidney 
tubes,  though  very  similar  cells  are  derived  from  the  urethra  in 
both  male  and  female.  Squamous  epithelium  points  to  the  cystic 
mucosa  and  is  not  increased  in  nephritis. 

Mucus  in  cylindroid  form  may  point  to  nephritic  congestion  or 
inflammation,  but  this  may  be  present  in  health,  and  may  show 
in  irregular  masses  derived  from  the  renal  pelvis  or  the  bladder. 
Mucous  casts  are  always  extremely  elastic  and  mobile,  and  lack 
the  even  clear  cut  margins  of  the  casts  of  nephritis.  They  are 
much  more  common  in  horse's  urine  than  in  that  of  other  animals. 

Tube  casts  are  especially  indicative  of  nephritis  and  exuda- 
tion into  the  uriniferous  tubes.  They  are  much  firmer  than  the 
mucous  cylinders  and  have  smoother  and  more  even  margins. 
If  relatively  thick  and  straight  they  probably  come  from  the 
straight  tubes  ;  if  sinuous  or  twisted,  from  the  convoluted  tubes. 
With  a  similar  basis  substance  they  often  enclose  different  solid 
bodies  and  have  been  named  accordingly : — epithelial  casts 
when  containing  cylindroid,  or  polyhedral  cells  may  be  unhesi- 
tatingly referred  to  the  uriniferous  tubules  : — granular  casts  in 
15 


226  Veterinary  Medicine, 

which  the  homogeneous  cast  is  impregnated  with  granular  cells 
and  free  granules  of  proteid,  fatty,  or  mineral  matter,  point 
directly  to  inflammation  affecting  the  uriniferous  tubules  and 
their  epithelial  lining  : — ^blood  casts  enclosing  red  blood  globules 
Imply  hemorrhage,  or  congestion  or  inflammation  of  the  tubules, 
with  blood  extravasation  or  diapedesis : — casts  containing 
leucocytes  and  pus  cells  bespeak  suppurative  inflammation  of 
the  tubules  : — calcareous  casts  entangle  numerous  crystals  and 
granules,  mainly  of  lime  carbonate,  and  effervesce  with  acetic 
acid  : — ^hyaline  casts  are  homogeneous,  clear,  so  transparent 
that  it  is  sometimes  necessary  to  stain  them  with  iodine  or  ani- 
line to  make  them  distinct ;  they  are  found  in  nephritis  and 
especially  in  the  chronic  forms  : — colloid  casts  or  waxy  casts, 
or  amyloid  casts  may  designate  a  class  of  firmer  cylinders, 
clear,  homogeneous  and  refractive,  and  often  bearing  fatty,  or 
blood  globules,  crystals  or  fungi.  They  may  have  a  yellow 
color,  or  they  may  give  the  amyloid  mahogany  reaction  with  the 
iodo-potassic  iodide  solution  (even  in  the  absence  of  amyloid  de- 
generation of  the  kidney  ;  Jaksch). 

Progress.  Acute  nephritis  may  advance  for  three  days  or  more 
and  then  terminate  in  resolution,  or  go  on  to  complete  anuria 
with  coma,  to  suppuration,  gangrene  or  chronic  nephritis. 

Resolution  is  marked  by  general  improvement  of  pulse, 
breathing  and  expression,  clearing  of  the  urine,  and  return  of 
appetite.  The  urine  may  remain  albuminous  for  eight  days 
longer. 

Complete  suppression  of  urine  has  persisted  five  days  in 
cattle  (Funk),  and  seven  days  in  horses  (Friedberger),  accom- 
panied by  intense  fever,  dullness,  stupor  and  coma  ending  in 
death  from  uraemia. 

Purulent  urine  is  white,  milky,  albuminous,  granular,  with 
epithelial  cells  and  casts  and  pus  cells,  showing  their  double  nuclei 
with  acetic  acid.  There  are  usually  rigor,  hyperthermia  (io6® 
F.),  thirst,  intermittent  colics,  diarrhoea,  perspiration,  uncertain 
walk,  and  stocked  legs.  Convulsions  have  been  noticed  in  the 
horse  (Didie),  cow  (Pflug)  and  bitch  (Trasbot).  The  horse  may 
turn  in  a  circle  (Friedberger)  or  have  amaurosis  (Didie).  Death 
usually  occurs  in  two  weeks, 

Gangrene  is  likely  to  prove  fatal.     Berger  has  seen  death  oc- 


Acute  Nephritis,     Acute  Bright' s  Disease.  227 

cur  in  three  days  in  the  horse,  and  Trasbot  in  four  days  in  a  cow, 
after  a  large  cantharides  blister. 

Pathological  Anatomy,  The  kidney  is  enlarged,  soft,  friable, 
dark  red,  yellow  with  red  spots,  or  having  areas  of  hemorrhage. 
When  fatty  it  is  marbled,  pale  yellow  or  white  and  red.  The  cap- 
sule is  easily  detached.  On  section  it  is  bloody,  oozing  or  even 
dropping  blood,  or  a  pale  creamy  fluid.  The  pelvis  contains 
urine,  thick,  gelatinoid,  bloody  or  purulent.  The  latter  condi- 
tion must  not  be  confounded  with  the  thick  pus-like  mucus  which 
normally  occupies  the  renal  pelvis  in  the  horse. 

The  lesions  of  the  secreting  portions  of  the  kidney  will  vary 
with  the  concentration  of  the  inflammation  in  one  or  other  of 
the  separate  tissues. 

In  glomerulitis  from  toxic  irritants,  the  capsules  enclose  an 
albuminous  liquid  exudate,  the  capillaries  are  overdistended, 
their  walls  thickened  and  cloudy,  and  thrombi  with  an  excess  of 
red  globtdes  and  leucocytes  block  them  at  intervals.  This  capil- 
lary obstruction  extends  to  the  plexus  surrounding  the  convoluted 
tubules. 

In  tubular  nephritis  there  is  congestion  of  the  plexus  cover- 
ing the  convoluted  tubes,  and  the  epithelium  shows  cloudy  swell- 
ing, with  fatty  granules  and  hyalin  droplets  in  the  desquamating 
cells. 

With  interstitial  nephritis  there  is  an  exudate  into  the  in- 
terstitial connective  tissue  between  the  tubules,  and  into  the 
tubules  forming  hyaline  casts.  The  epithelium  of  the  tubules  are 
swollen,  granular,  opaque  and  desquamating. 

In  suppurative  nephritis  may  be  found  all  stages  of  ab- 
cedation  from  minute  points,  gray  or  yellow,  and  only  just  visible 
to  the  naked  eye,  in  the  midst  of  the  deep  red  congested  tissues, 
through  the  larger  white  suppurative  areas,  to  the  extensive 
abscess  formed  by  a  coalescence  of  the  many,  the  intervening 
tissue  having  broken  down  by  a  necrotic  disintegration.  In  the 
earlier  stages  the  pus  infiltrates  the  parenchyma  so  that  it  may  be 
comparable  to  a  sponge  filled  with  this  liquid. 

Treatment.  The  first  consideration  is  rest,  with  a  warm  build- 
ing or  clothing  to  solicit  the  action  of  the  skin  and  lessen  the 
work  of  the  kidneys.  Warm  summer  weather  is  favorable,  or 
we  should  secure  a  sunny,  comfortable,  loose  box,  or  a  building 


228  Veterinary  Medicine, 

heated  by  a  stove.  In  default  of  this,  warm  woolen  blankets, 
hood  and  leg  bandages  should  be  secured.  If  the  case  is  mild 
enough  to  allow  of  appetite,  the  food  for  herbivora  may  be  green 
food  in  summer  and  carrots,  beet,  turnip,  potato  or  ensilage  in 
winter.  The  dog  may  have  buttermilk  or  sweet  milk  or  mush 
and  milk.  Meat  is  objectionable  because  of  the  amount  of  urea 
and  other  urinary  products  which  it  produces. 

Trasbot  strongly  recommends  general  bleeding  in  strong, 
vigorous  horses  and  cattle,  attacked  by  the  disease  in  an  acute 
form,  but  deprecates  it  in  the  lymphatic,  fat,  or  debilitated. 

Omitting  the  general  bleeding,  one  can  always  find  a  good  and 
safe  alternative  in  bleeding  the  animal  into  his  own  tissues. 
Shaving  the  loins  and  cupping  has  often  an  excellent  effect.  An 
approach  to  this  may  be  had  by  vigorous  rubbing  by  several  men 
at  once,  of  the  limbs  and  the  whole  surface  of  the  body,  by  warm 
fomentations  over  the  loins  by  means  of  spongio-piline  or  sur- 
geon's cotton  covered  with  dry  blankets,  or  by  winding  a  hose 
round  the  body  through  which  warm  water  is  forced,  or  finally 
by  a  bath  of  steam  or  hot  air,  or  in  small  animals  of  warm  water. 
The  dog  may  be  placed  in  a  bath  of  80**  or  90°  F.,  which  is  al- 
lowed to  gradually  cool  to  65°  or  70°.  In  all  these  cases  the 
greatest  care  must  be  taken  to  avoid  chill  when  the  animal  is 
taken  out.  He  should  be  quickly  rubbed  dry  in  a  warm  room 
and  blanketed. 

Counter-irritants  act  in  the  same  way,  and  mustard,  or  hot 
water  hotter  than  the  hands  can  bear  may  be  applied.  Turpen- 
tine, cantharides  and  other  diuretic  counter-irritants  must  be 
carefully  avoided.  An  old  practice  of  la3ring  a  freshly  removed 
sheep  skin  over  the  loins,  with  the  flesh  side  inward,  often  causes 
a  distinct  exudation,  thickening  of  the  skin  and  derivation. 

A  damp  cloth,  laid  across  the  loins  and  thoroughly  covered 
with  dry  to  prevent  any  evaporation  and  chill,  will  usually  give 
great  relief  and  may  be  kept  on  for  days. 

Internal  medication  must  at  first  be  mainly  anodyne,  laxative 
and  diaphoretic.  The  two  latter  classes  are  at  once  derivative 
and  eliminating,  carrying  out  through  other  channels,  waste 
products  that  would  otherwise  have  taxed  the  kidneys. 

Among  anodynes,  the  bromide  of  camphor  (horse,  1-2  drs., 
dog,  2  to  5  grs.),  bromide  of  potassium  (horse,  i  dr.,  dog,  i  to  3 
grs.)  or  hyoscyamus  may  be  used,  and  repeated  twice  daily. 


Acute  Nephritis,     Acute  Bright' s  Disease.  229 

Purgatives  must  be  restricted  to  such  as  have  no  tendency  to 
act  on  or  irritate  the  kidneys.  Castor  oil,  or  sweet  oil  for  the 
larger  animals,  or  for  the  dog  senna  or  jalap,  may  be  given  every 
morning  to  secure  free  movement. 

As  diaphoretics,  ipecacuan,  Dover's  powder,  tartar  emetic  and 
even  pilocarpin  may  be  used.  The  last  named  agent  is  especially 
useful  when  dropsy  sets  in,  or  uraemic  stupor  or  coma  threatens 
(horse  3  g^.,  ox  7  grs.,  dog  i  to  ^  g^.  according  to  size).  If 
the  heart  shows  weakness  it  must  be  sustained  by  digitalis, 
strophanthus,  caffein  or  nitroglycerine,  and  the  pilocarpin  with- 
held. 

In  a  sufficiently  strong  subject  the  stupor  or  coma  may  be  met 
by  the  abstraction  of  blood,  which  benefits  by  the  dilution  of  that 
which  is  left. 

Eclampsia  may  be  further  met  by  the  inhalation  of  ether  or 
chloroform,  or  the  rectal  injection  of  chloral  or  bromide  solution. 

As  the  inflammation  abates,  if  the  action  of  the  kidney  is  still 
insufficient  in  spite  of  the  free  drinking  of  pure  water,  alkaline 
diuretics  may  be  given  in  small  doses  (tartrate,  acetate  or  citrate 
of  potash,  bicarbonate  of  soda,  saltpeter). 

In  excessive  dropsy  avoid  sloughing  by  lancing  the  most  tersely 
swollen  parts  to  allow  drainage,  and  keep  the  parts  disinfected 
with  carbolic  or  other  antiseptic  lotion.  For  ascites  or  hydro- 
thorax,  aspirate,  and  apply  a  compressory  bandage. 

During  convalescence  a  course  of  bitters  (cinchona,  salicin, 
gentian,  nux  vomica)  and  iron  (phospho- tartar,  iodide  or  phos- 
phate) will  often  be  called  for.  Anaemia  may  be  met  by  doses  of 
peroxide  of  hydrogen  or  the  inhalation  of  oxygen. 

In  the  advanced  stages  benefit  may  accrue  from  the  use  of 
small  doses  of  cubebs,  copiaba,  oil  of  turpentine  or  buchu,  which 
liave  a  tonic  action  on  the  renal  mucosa. 


PURULENT  NEPHRITIS. 

Causes :  general,  traumatic,  metastatic,  infective,  wounds,  shocks,  strains, 
blows,  falls,  crowding,  heavy  loads,  calculi,  infective  embolism.  Lesions  : 
miliary  or  large  abscessea,  diffuse  suppuration,  softening,  disintegration, 
fistula.  Symptoms  :  obscure,  nephritic  symptoms  following  distant  abscess, 
chill,  hyperthermia,  (general  symptoms  6f  nephritis,  pus  in  urine,  ansemia, 
emaciation.  Treatment :  to  external  wound,  antiseptics,  evacuate  abscessi 
extirpate  kidney  with  pyonephrosis,  in  dog  or  pig,  calcium  sulphide,  sul- 
phites, copiaba. 

Causes,  Aside  from  the  main  causes  of  nephritis,  the  sup- 
purative form  may  be  determined  by  traumatic  or  metastatic 
infective  conditions.  Under  traumatic  factors  may  be  named 
punctured  or  gunshot  wounds,  shocks  and  strains  connected 
with  falls,  blows,  crowding,  compression,  too  heavy  weights  on 
the  back  (pack,  rider,  two  wheeled  cart  loaded  too  heavily 
forward  and  going  down  hill),  and  finally  calculi  in  the  urini- 
ferous  tubules.  Under  metastatic  factors  come  all  infections, 
pyaemia,  omphalitis,  any  suppurative  affection  of  the  lungs> 
(abscess,  pneumonia,  broncho-pneumonia),  pharangitis,  etc. 
Embolic  renal  abscess  may  start  from  endocarditis,  arteritis,  or 
ptdmonary  phlebitis. 

Lesions,  There  may  be  a  circumscribed  renal  abscess  like  a 
good  large  orange,  or  many  small  gray  spots  like  millet  seeds, 
peas  or  hazel  nuts,  having  purulent  centres  and  containing  pus 
cocci  or  bacilli.  In  other  cases  a  diffuse  inflammation  suppur- 
ates throughout  till  the  whole  gland  becon^es  a  pulpy  mass  of 
pus,  blood  and  broken  down  kidney  tissue  (pyonephrosis). 
In  traumatic  cases  the  pus  centres  around  the  wound  or  injury, 
perhaps  invading  adjacent  parts,  and  even  communicating 
through  the  skin  externally  along  the  line  of  the  original  wound. 
The  pus  may  burrow  in  different  directions  in  the  cortex  or 
under  the  capsule  with  abscess  at  intervals  (perinephritis),  or 
along  the  vessels  to  the  medullary  structure. 

Symptoms.  These  are  often  obscure.  The  sudden  appearance 
of  kidney  disease  in  the  course  of  a  suppurative  affection  else- 
where, the  extension  being  ushered  in  by  a  chill  or  rigor  or 
attended  by  a  succession  of  these,  and  the  course  marked  by 
230 


Purulent  Nephritis,  231 

a  variable  hyperthermia  is  very  suggestive.  StiflFness  and  weak- 
ness of  the  hind  parts  and  tenderness  of  the  loins  are  sigifi- 
cant ;  also,  in  camivora  and  omnivora,  nausea  and  vomiting. 
When  the  kidney  can  be  felt  by  the  hand  in  the  rectum  or  in 
the  small  animals,  through  the  flaccid  abdominal  walls,  the 
manifest  enlargement,  the  tenderness,  and  in  some  cases  even 
fluctuation  will  assist  in  diagnosis.  In  such  cases,  puncture  by 
a  large  h3rpodermic  needle,  or  a  small  trochar  may  betray  the 
presence  of  pus  and  complete  the  diagnosis.  If  the  pus  escapes 
i^to  the  pelvis  of  the  kidney  it  may  be  recognized  in  the  urine. 
The  case  is  very  liable  to  become  chronic,  and  is  then  marked 
by  anaemia  and  emaciation. 

Treatment.  When  an  external  wound  exists  it  must  be  treated, 
antiseptically,  with  boric  acid,  potassium  permanganate,  or  other 
antiseptic  lotion.  If  a  single  large  abscess  exists,  puncture  evac- 
uation through  needle  or  trochar,  and  washing  out  with  an  anti- 
septic solution  is  the  obvious  resort.  Any  foreign  body  must  of 
course  be  removed.  If  the  suppuration  is  diffused  through  the 
whole  mass  of  softened  kidney,  the  resort  of  extirpation  may  be 
considered.  This  is  always  dangerous  as  provocative  of  infec- 
tious peritonitis,  but  it  is  less  so  in  dogs  and  swine  than  in  other 
animals  owing  to  their  natural  antagonism  to  pus  microbes.  The 
operation  should  be  attempted  extraperitoneally,  the  incision  be- 
ing made  beneath  the  anterior  lumbar  transverse  processes  and 
carried  inward  through  the  sublumbar  connective  tissue.  The 
renal  aftery  will  require  ligature  with  antiseptic  catgut  and  all 
manipulations  should  be  aseptic  or  antiseptic.  Even  if  successf  td, 
this  operation  leaves  the  subject  in  a  dangerous  state,  as  in  case 
of  kidney  disease  at  any  future  time,  there  is  no  second  kidney 
to  compensate  for  the  temporary  loss  of  function  and  uraemic 
poisoning  is  to  be  dreaded. 

Apart  from  surgical  measures  the  general  treatment  would  be 
largely  the  same  as  for  acute  infectious  nephritis.  As  antiseptics 
calcium  stdphide,  the  different  sulphites,  copiaba,  etc.,  will  be 
indicated. 


PERI-NEPHRITIS. 

Definition.  In  cattle  on  low  damp  lands,  acrid  plants,  sprain,  blow,  cal- 
culus, from  pumlent  nephritis,  in  aneemia.  Symptoms  :  of  nephritis,  soil- 
ing of  tail  or  prepuce,  albumen,  pus  or  blood  in  urine,  lameness,  unilateral 
or  bilateral,  lumbar  swelling,  in  small  animals  fluctuation,  history.  Lesions : 
abscesses  around  kidney,  under  capsule,  intercommunicating.  Treatment : 
as  in  purulent  nephritis. 

Suppuration  in  the  connective  tissue  between  the  kidney  and 
its  capsule  is  seen  in  cattle  in  low  conditioii,  on  damp,  un- 
improved soils  like  undrained  river  bottoms  and  estuaries, 
abounding  in  acrid  and  diuretic  plants.  Even  among  such  ani- 
mals it  is  rare  and  has  probably  a  directly  exciting  cause  in  a 
sprain<  or  blow  on  the  loins,  or  the  presence  and  movement  of  a 
renal  calculus.  It  may  extend  from  suppurations  in  the  sub- 
stance of  the  kidney  and  to  such  extension  the  weak  or  anaemic 
condition  materially  contributes.  In  man,  in  which  such  condi- 
tions have  been  more  frequently  observed,  a  weak  or  cachetic 
condition  is  considered  as  an  essential  accessory  factor  along  with 
the  traumatic  lesion  (R.  Harrison).  Similar  conditions  may  be 
expected  to  bring  about  peri-nephritis  in  any  one  of  our  domestic 
animals.  The  author  has  observed  it  especially  on  the  low  lands 
on  the  banks  of  the  Ouse  in  Yorkshire,  England. 

Symptoms,  These  are  mainly  those  of  nephritis  in  general, 
shivering,  sti£F  movement  in  the  hind  limbs,  straddling,  frequent 
passage  of  urine,  straining,  difficulty  in  lying  down  and  rising, 
tenderness  of  the  loins,  dropping  when  mounted,  groaning  when 
turned  in  a  short  circle.  If  the  suppuration  communicates  with 
the  pelvis  of  the  kidney  there  may  be,  in  females,  soiling  of  the 
tail,  and  in  males  of  the  prepuce.  Blood  may  be  passed  with  the 
urine,  and  pus  cells  and  albumen  are  found  when  it  is  examined. 
If  one  kidney  only  is  aflFected,  there  is  lameness  in  the  corre- 
sponding hind  limb,  the  special  feature  being  inability  to  extend 
it  backward.  A  swelling  on  the  one  side  of  the  loins,  and  be- 
neath the  lumbar  transverse  processes  ji'st  posterior  to  the  last 
rib,  is  likely  to  be  a  marked  symptom,  and  if  this  persists  and  is 
especially  prominent  at  one  point,  an  exploratory  incision  or 
232 


Pyelitis,  Pyelo-nephritis,  Inflammation  of  the  Renal  Pelvis.  233 

puncture  will  detect  the  presence  of  the  pus.  Fluctuation  can 
rarely  be  detected,  yet  in  small  animals  with  very  flaccid  ab- 
domen, the  swollen,  tender  kidney  and  even  fluctuation  should 
be  detected  at  times.  The  history  of  the  case,  the  low,  damp 
pasturage,  the  access  to  acrid  plants,  the  alimentation  with  hay 
or  grain  covered  with  cryptogams,  the  fact  of  an  injury  and  the 
low,  weak,  anaemic  condition  of  the  animal  should  contribute  to 
a  satisfactory  diagnosis. 

Lesions,  In  bovine  kidneys  aflFected  in  this  way  we  have  found 
general  inflammation  and  exudation  around  the  entire  kidney  and 
inside  the  capsule,  with  numerous  small  abscesses,  in  many 
instances  communicating  with  each  other.  They  may  extend 
through  the  capsule  and  invade  surrounding  organs. 

Treatment,  In  the  treatment  of  cases  of  this  kind  the  general 
principles  of  therapeutics  for  nephritis  are  about  all  that  can  be 
attempted  in  the  lower  animals.  Fomentations  over  the  loins  are 
especially  desirable  as  a  means  of  relieving  the  suffering,  and 
moderating  inflammatory  action.  To  the  same  end  is  the  allow- 
ance of  plenty  of  pure  water  as  a  diluent.  Then  the  various 
agents  that  antagonize  suppuration  may  be  thought  of,  and  some 
one  selected  for  use.  Beside  the  antisuppurants  already  men- 
tioned one  may  use  copiaba,  cubebs,  or  turpentine  in  small  doses, 
salicylates,  or  the  sulphide  or  sulphite  of  calcium.  Surgical  inter- 
ference by  puncture  or  incision  and  antiseptic  irrigation  can  only 
be  thought  of  when  the  abscess  is  single  and  circumscribed  ;  never 
when  the  whole  periphery  of  the  organ  is  involved.  In  the  latter 
case  the  only  rational  surgery  would  be  the  desperate  resort  of  the 
removal  of  the  entire  kidney. 


PYELITIS.     PYELO-NEPHRITIS.     INFLAMMATION  OF 
THE  RENAL  PELVIS. 

Definition.  Canaes  :  primary  from  vegetable  irritanta  in  food,  toxina, 
cryptogama,  pelvic  calculua,  strongylua  gigas ;  secondary  from  renal  calcu- 
lus, parasite,  tubular  uretral  or  vesical  infection,  infecting  deposits,  metasta- 
sis. Symptoms  :  as  in  nephritis,  pus,  blood,  or  albumen  in  urine,  tender, 
arched  loins,  purulent  polyuria,  with  spheroidal  epithelium.  Diaj^osis. 
Lesions:  inflammation,  calculus,  etc.,  in  pelvis.  Treatment:  pure  water, 
aodium  bicarbonate,  antiseptics,  bslsams,  fomentations,  piperazin,  extraction 
of  calculus. 


234  Veterinary  Medicine, 

Suppurative  inflammation  of  the  mucosa  lining  the  renal  pelvis 
may  occur  in  the  acute  or  chronic  form. 

Causes.  It  may  be  either  primary  or  secondary.  As  a  primary 
disease  it  may  be  the  result  of  poisoning  by  irritant  diuretics  such 
as  cantharides,  turpentine,  colchicum  or  balsams,  or  shoots  of  the 
coniferae,  it  may  be  due  to  the  passage  of  the  irritant  products  of 
cryptogams  found  in  musty  fodder,  or  grain,  or  it  may  come  from 
the  irritation  caused  by  the  toxins  of  bacteria  developed  in  the 
system  or  in  food  or  drink.  Cases  that  develop  from  the  irritation  . 
of  a  pelvic  calculus  or  precipitate,  and  from  the  presence  of  the 
strong^lus  gigas  (in  dogs)  may  also  be  placed  in  this  class. 

As  secondary  causes  are  those  in  which  the  inflammation  start- 
ing in  the  uriniferous  tubes  extends  down  to  and  implicates  the 
pelvis,  and  the  still  more  frequent  instances  of  extension  of  puru- 
lent infection  upward  from  the  ureter,  bladder  or  prostate,  so  as  to 
involve  the  pelvis.  So  in  blocking  of  the  urethra  by  strongylus, 
stricture,  clot  or  calculus,  and  in  spasm  of  the  sphincter  vesicae, 
the  delayed  urine  is  liable  to  undergo  fermentation  with  evolution 
of  ammonia,  and  not  only  the  bladder  but  the  ureter  and  renal 
pelvis  may  suffer.  Again,  the  occurrence  in  the  kidney  of  the 
hyperplasia  of  cancer,  glanders  (horse)  and  tuberculosis  (cow) 
may  be  the  direct  cause  of  pyelitis.  Similarly  foci  of  infection  in 
the  kidney  may  be  found  in  distemper  in  the  dog,  and  in  the  con- 
tagious pneumonia  and  influenza  of  the  horse.  In  man  infection 
from  the  bowel  through  the  migration  of  the  bacillus  coli  com- 
munis to  the  devitalized  kidney  and  contents  in  hydronephrosis, 
has  been  trsiced,  and  the  liability  to  this  must  be  still  greater  after 
the  surgical  insertion  of  the  ureters  in  the  rectum  as  a  substitute 
for  the  obliterated  bladder  and  urethra.  Again,  in  the  intra-ar- 
terial  migrations  of  the  strongylus  (sclerostoma)  armatus  pus 
microbes  may  be  carried  to  the  kidney  and  reach  the  pelvis. 

Symptoms,  These  are  in  the  main  those  of  nephritis  with 
marked  rigors.  The  presence  of  pus  cells  and  albumen  in  the 
urine  may  come  from  suppuration  in  the  substance  of  the  kidney 
itself,  or  sub-capsular  abscess  opening  into  the  pelvis,  or  it  may 
come  from  cystitis,  prostatitis  or  urethritis.  The  special  stiffness 
and  tenderness  of  the  loins,  polyuria  in  which  the  liquid  is  puru- 
lent, but  free  from  uriniferous  casts,  and  in  which  it  is  charged 
with  the  spheroidal  epithelium  of  the  pelvis  (not  the  columnar  of 


Pyelitis.     Pyelo-nephritis,     Inflammation  of  the  Renal  Pelvis.  235 

the  tubules),  may  afFord  presumptive  evidence  of  pyelitis.  But 
pyelitis  is  usually  combined  with  nephritis  or  cystitis  and  the  com- 
plications prevent  diagnosis.  In  some  cases  the  urine  is  scanty 
and  strongly  albuminous,  and  in  others  a  round  calculus  will 
block,  at  intervals,  the  opening  of  the  ureter  giving  rise  to 
obstruction  of  the  flow  from  that  kidney  and  the  occurrence  of 
violent  renal  colic  lasting  until  the  stone  i^  again  dislodged  back- 
ward. 

Diagnosis  cannot  often  be  certain.  Purulent  urine,  with  a 
considerable  number  of  the  spheroidal  cells  of  the  pelvis,  and  the 
general  signs  of  nephritis  may  be  taken  as  diagnostic.  A  great 
excess  of  such  epithelial  cells  would  on  the  contrary  point  to 
cystitis. 

Lesions.  In  the  early  stages  the  mucosa  of  the  pelvis  is  con- 
gested, red,  aud  sometimes,  with  calculus,  haemorrhagic.  Later 
it  becomes  thickened  by  exudate,  which  fills  also  the  submucous 
tissue.  In  some  instances  the  pelvis  is  distended  by  an  impacted 
calculus,  in  others  the  obstruction  of  the  ureter  by  an  impacted 
calculus  or  a  swelling  has  led  to  overdistension  of  the  pelvis,  and 
ammoniacal  fermentation  of  its  contents.  Coincident  inflamma- 
tory lesions  of  the  kidneys,  ureter,  or  bladder  are  common. 

Prognosis  is  not  hopeful.  Where  it  has  resulted  as  a  descend- 
ing infection  from  the  kidneys,  the  severity  of  the  primary  lesion 
renders  the  case  a  grave  one,  while  if  it  has  been  an  ascending  in- 
flammation from  the  bladder  it  is  no  less  so. 

Treatment.  Diluent  (watery)  diuretics  are  especially  indicated. 
Pure  water  may  be  given  ad  libitum.  To  this  may  be  added  if 
necessary  moderate  doses  of  bicarbonate  of  soda  or  potash  with 
such  non-irritating  antiseptics  as  salicylic  acid,  salicylate  of  soda, 
sulphite  of  soda,  sulphide  of  calcium,  quinia  or  chamomile.  Tras- 
bot  even  recommends  small  doses  of  vegetable  astringents,  balsam 
of  Tolu,  or  Peru  or  of  Copiaba,  or  oil  of  turpentine  or  tar  water. 
Apart  from  simple  water,  the  diuretic  agents  may  be  used  with 
greater  freedom  if  the  solid  parts  of  the  kidney  are  little  or  not  at 
all  involved  and  if  the  urine  contains  no  casts  of  the  uriniferous 
tubes. 

Benefit  may  also  be  obtained  from  fomentations,  or  cupping  of 
the  loins,  and  even  from  the  application  of  mustard  and  counter- 
irritants. 


236  Veterinary  Medicine, 

If  the  active  symptoms  subside  the  continued  use  of  tonics 
would  be  indicated,  especially  quinia,  and  also  of  the  balsams  with 
the  view  at  once  of  antisepsis  and  toning  up  of  the  mucous  mem- 
brane. 

In  case  of  calctdus  of  the  pelvis  surgical  extraction  is  virtually- 
the  only  resort,  though  a  very  desperate  one.  Its  increase  may 
be  retarded  or  prevented  by  antisepsis,  a  liberal  use  of  water,  and 
the  exhibition  of  piperazin  or  some  of  the  essential  oils. 


CHRONIC  NEPHRITIS. 

Cases  destroyed  as  eating  their  heads  off.  Causes  :  sequel  of  acute  nephri- 
tis, swill,  lead,  experimentally,  microbian  invasions,  toxins,  metastatic  em- 
bolism, extension  from  aortic  disease,  sclerostoma,  nitrogenous  overfeeding, 
toxins  of  putrid  food,  or  cryptogams,  valvular  disease  of  the  right  heart, 
rheumatism,  heaves,  calculus,  starvation,  debility,  retention  of  urine. 
Symptoms:  emaciation,  flabby  muscles,  lack  of  vigor,  stiff  loins  and 
quarters,  short  step,  straddling,  fatigue  under  slight  exertion,  groaning  in 
trot,  or  in  turning,  droops  when  mounted,  slow  to  rise  on  hind  limbs,  poor 
capricious  appetite,  anaemia,  stocked  legs,  dropsies,  urine  of  lower  density, 
albuminous,  with  granular  epithelium  and  casts,  abundant  in  early  stages, 
scanty  with  weakened  heart  and  degenerated  kidneys.  Secondary  palpita- 
tions, bronchial  catarrh,  pneumonia,  hemorrhage,  stupor,  lethargy,  vertigo, 
etc.  Lesions  :  recent  cases,  kidney  large,  cortex  firm,  capsule  adherent, 
with  fi^ranular  fatty  debris,  and  tubular  casts ;  old  cases,  kidney  contracted, 
fibroid,  glomeruli  and  tubules  atrophied.  Bronchitis,  pneumonia,  hepatic 
cirrhosis,  heart  enlarged,  fatty,  dilated,  iuhufficient  valves.  Prognosis  un- 
favorable Treatment :  gentle  exercise,  warmth,  succulent  food,  amylaceous, 
tonics,  iron,  bitters,  mineral  acids,  heart  tonics,  for  polyuria  bromides  or 
iodides,  balsams,  pilocarpin.  fomentations  or  sinapisms  to  loins. 

Chronic  nephritis  has  reeeived  little  attention  in  the  lower  ani- 
mals for  various  reasons.  The  lower  animals  largely  escape  the 
causative  factors  of  alcholism  and  chronic  lead  and  copper  pois- 
oning, and  when  suffering  from  any  chronic  affection  that  dis- 
qualifies the  animal  for  use  and  renders  it  anaemic  and  emaciated 
it  is  naturally  sacrificed  to  save  the  cost  of  maintenance.  In  spite 
of  this  a  considerable  number  of  cases  have  been  recorded  in 
horses,  and  cattle  and  especially  in  dogs  and  cats. 

Causes,  Cases  of  acute  nephritis  sometimes  improve  and  give 
promise  of  recover}' without  completing  the  work  of  convalescence. 


Chronic  Nephritis,  237 

Trasbot  notes  such  cases  in  the  dog,  and  Dickinson  in  the  ox. 
Alcoholic  nephritis  and  degenerations  are  to  be  sought  for  espe- 
cially in  cattle  kept  on  distillery  and  brewery  dregs.  Lead  taken 
in  small  quantities  in  soft  water  that  has  run  through  lead  pipes 
or  stood  in  leaden  cisterns  produces  in  cows  and  other  animals 
chronic  a£Fections  of  the  kidney.  EUenberger  and  HoflFmeister 
have  produced  the  disease  experimentally  with  lead  and  copper 
respectively. 

Microbian  invasions  of  the  kidney  that  advance  slowly  like 
glanders  and  tubercle  are  further  causes  of  chronic  nephritis. 
Other  secondary  microbian  infections  of  the  kidney  are  complica- 
tions of  infectious  diseases  in  other  parts,  including  abscess, 
pyaemia,  septicaemia,  ulcerative  endocarditis  of  the  left  heart, 
bronchitis,  pneumonia,  (Frohner),  and  of  others  less  directly  in 
the  line  of  the  circulation,  as  omphalitis,  uterine  phlebitis  (Lustig), 
abscess  of  the  nasal  sinuses,  bones,  and  fistulae  (Trasbot). 

In  other  cases  the  nephritis  is  evidently  a  result  of  the  irritation 
caused  by  toxins  in  process  of  elimination  by  the  kidneys,  as 
there  is  no  evidence  of  a  nephritic  infection. 

In  some  instances  minute  emboli  originating  in  the  lungs  or 
heart,  become  the  starting  point  of  the  nephritis,  which  slowly 
extends  by  reason  of  infection  or  low  condition  and  special  sus- 
ceptibility. Disease  of  the  aorta  or  renal  artery  may  lead  to  this 
condition  as  noticed  by  Cadeac  and  Lustig.  Cadeac  has  also 
noticed  its  association  with  aneurism  of  the  mesenteric  arteries  so 
that  the  strongylus  (sclerostoma)  armatus  may  be  considered  as  a 
factor.  Again  in  old  horses  and  dogs  it  has  been  associated  with 
atheroma  of  the  aorta  and  renal  vessels  (Trasbot). 

Overfeeding  is  not  without  its  influence,  especially  when  on  ani- 
mal food,  which  charges  the  kidneys  with  excreting  an  excess  of 
the  irritating  urea  and  uric  acid,  and  this  is  one  reason  why  it  is 
far  more  frequent  in  house  dogs  than  in  other  domestic  animals. 
When  the  meat  is  already  decomposing  and  putrid  there  is  the 
added  evil  of  a  quantity  of  toxins  and  even  of  microbes  to  be  elimin- 
ated from  the  system  by  the  much  abused  kidneys.  Add  to  these 
that  the  dog*s  urine  is  even  in  the  normal  condition  more  dense 
and  contains  more  irritating  ingredients  than  that  of  herbivora, 
and  that  owing  to  the  slight  activity  of  his  perspiratory  apparatus 
he  can  obtain  less  relief  from  the  skin,  and  we  find  a  substantial 
ground  for  the  prevalence  of  chronic  nephritis  in  this  animal. 


238  Veterinary  Medicine, 

Disease  of  the  valves  of  the  right  heart  or  dilatation  with  in- 
suflSciency  of  the  auriculo- ventricular  valves  is  a  potent  cause  of 
nephritis,  the  reflux  of  blood  into  the  veins  and  the  increased 
venous  tension,  speedily  producing  passive  congestion  and  a  slow 
type  of  inflammation  in  the  kidney.  This  factor  is  especially 
liable  to  operate  in  dogs,  which  are  particularly  obnoxious  to 
rheumatism  and  valvular  ulceration,  and  are  very  subject  to 
nervous  cardiac  disorders  ;  in  horses  that  have  contracted  heaves  ; 
and  in  beef  breeds  of  cattle  which  suffer  from  fatty  degeneration 
of  the  heart  with  dilatation. 

The  influence  of  calculi  must  not  be  overlooked,  whether  they 
are  lodged  in  the  pelvis,  the  chalices,  or  the  uriniferous  tubules. 
Their  tendency  is  to  induce  local  irritation  and  exudation,  with 
fibroid  degeneration  and  thickening  of  the  walls  of  the  tubules  or 
pelvis  and  of  the  adjacent  tissue. 

When  to  one  or  more  of  the  above  conditions  there  are  added 
overfeeding  or  what  is  worse  a  low  condition  from  starvation  or 
unwholesome  food  (permeated  by  bacteria  or  cyptogams  or  con- 
taining vegetable  acids),  and  when  to  crown  all  there  are  fre- 
quent exposures  to  cold  or  wet,  we  have  a  vicious  combination 
especially  conducive  to  kidney  trouble. 

Habitual  retention  of  urine  in  mares  in  harness,  in  house  dogs, 
or  in  horses  in  railway  cars,  and  violent  exertion,  or  sprains  of  the 
back  are  among  the  remaining  accessory  causes. 

Symptoms,  These  are  often  slight  or  obscure,  so  that  not  only 
owners  and  attendants  but  even  veterinarians  are  liable  to  over- 
look them.  Loss  of  flesh,  flabbiness  of  the  muscles  and  a  lack  of 
spirit  and  energy  are  among  the  first  symptoms.  The  horse  ap- 
pears stiff,  especially  in  his  loins  and  hind  limbs,  and  fails  to  ad- 
vance the  hind  feet  as  far  under  the  belly  as  formerly,  and 
straddles  more.  When  put  to  work  he  is  early  fatigued  and  ap- 
pears unfit  for  sustained  exertion.  His  movements  are  slow  and 
if  urged  to  a  trot  he  may  even  groan  with  every  step  and  quickly 
settles  back  to  his  sluggish  pace.  If  turned  sharply  round  on 
himself  he  does  so  with  difficulty  and  often  groans.  When  he  is 
mounted  or  when  the  loins  are  pinched  he  may  droop  to  excess. 
If  you  come  on  him  lying  down,  and  urge  him  to  rise  he  may 
rise  on  his  fore  limbs  and  sit  on  his  haunches  until  urged  before 
he  makes  any  attempt  to  raise  himself  on  his  hind.     The  dog  may 


Chronic  NepkriHs,  239 

spend  most  of  his  time  in  the  kennel,  and  show  little  disposition 
to  run,  play  or  hunt.  On  the  contrary  the  owner  may  have  to 
call  him  several  times  before  he  will  come  out  and  then  he  moves 
listlessly,  wearily  and  even  weakly. 

In  all  animals  the  appetite  is  poor  or  capricious,  and  the 
patient  gradually  loses  condition,  at  first  slowly  and  later,  after  a 
few  weeks  or  months,  more  rapidly.  The  advance  of  anaemia  is 
also  steadily  progressive. 

Dropsical  e£Fusion  is  not  uncommon.  It  is  often  prominent  in 
the  horse  as  stocked  limbs,  but  may  be  absent  for  a  length  of 
time.  In  other  animals  it  is  more  likely  to  appear  later  in  the 
disease  and  under  the  chest  or  abdomen  or  in  one  of  the  internal 
serous  cavities.  Trasbot  has  found  it  absent  for  months  in  the 
nephritic  dog. 

The  exploration  of  the  kidney  through  the  flaccid  abdominal 
ivalls  in  small  animals,  and  through  the  rectum  in  small  horses 
and  cattle,  may  reveal  renal  tenderness  and  even  swelling.  If 
there  is  a  tendency  to  frequent  passage  of  urine  in  small  quanti- 
ties, or  to  straining  without  micturition,  the  indication  is  of 
value. 

There  may  be  little  or  no  fever,  and,  when  left  at  rest,  little 
•evidence  of  discomfort. 

Any  indication  of  urinary  trouble,  and  especially  with  dropsy, 
weakness,  flabbiness  and  anaemia  and  a  .subnormal  temperature, 
should  lead  to  examination  of  the  urine,  as  a  crucial  test.  A 
high  density  is  good  ground  for  suspicion.  But  this  is  not  con- 
stant. In  advanced  cases  (chronic  interstitial  nephritis,  small 
white  kidney,  atrophic  nephritis)  it  may  be  1015  to  1025,  in  ex- 
ceptional advanced  cases  with  polyuria,  it  may  be  loio,  1005,  or 
•even  looi.  With  such  a  condition,  however,  there  is  great 
anaemia,  pallor  of  the  muscoae,  and  prostration.  Tested  with 
nitric  acid  and  heat,  the  urine  throws  down  an  abundant  precipi- 
tate of  albumen.  Under  the  microscope  it  shows  a  profusion  of 
granular,  degenerating  epithelial  cells,  and  casts  of  the  urinifer- 
ous  tubes. 

Progress.  The  course  of  the  disease  is  usually  slow,  extending 
over  several  months,  but  with  a  tendency  to  constant  advance. 
The  thirst  increases  and  the  urine  increases  in  an^ount,  clearness 
and  levity.     There  may  supervene  extreme  sluggishness,  drop- 


240  Veterinary  Medicine. 

sies,  anaemia,  and  weakness,  irritability  of  the  heart,  and  pal- 
pitations on  slight  exertion.  So  long  as  the  heart's  action  is 
strong,  elimination  may  be  maintained  and  life  prolonged  for 
months  (in  cow,  Dickinson),  oryears(FriedbergerandFr6hner). 
When  the  heart's  action  becomes  weak,  elimination  is  rendered 
imperfect  and  the  animal  shows  catarrh  of  the  lungs  or  bowels 
(common  in  dogs),  local  inflammation  of  the  lungs,  pleura  or 
pericardium,  or  cedemas,  or  haemorrhages.  The  toxic  eflFect  on 
the  nerve  centres  is  shown  by  stupor  or  lethargy,  or  vertigo. 
When  an  abscess  forms  it  is  associated  with  a  temporary  rise  of 
temperature  (Trasbot ).  The  patient  may  die  in  convulsions,  in  a 
state  of  coma,  or  by  gradually  advancing  debility  and  failure  of 
the  heart. 

Lesions,  In  cases  of  comparatively  short  standing  the  kidney 
is  usually  of  full  size,  or  somewhat  enlarged,  with  firmly  ad- 
herent capsule  and  rough  or  even  nodular  surface.  The  surface 
of  the  cortex  may  be  red  or  grayish  or  parti-colored,  pink  and 
gray.  The  cortical  portion  is  firm  and  it  may  even  be  attenuated 
somewhat,  while  the  medullary  portion,  naturally  lighter,  has 
often  grayish  streaks  converging  toward  the  hilus.  When  the 
gray  streaks  are  scraped  with  the  knife  a  serous  fluid,  mixed  with, 
fatty  granules  or  globules,  is  obtained.  The  glomeruli  may  be 
still  about  the  normal  size  with  some  increase  of  the  epithelial 
tuft  cells.  The  tubules  contain  casts  (colloid,  hyaline,  granular), 
and  their  epithelium  normally  columnar,  are  flattened  down  to- 
cubes  and  are  swollen,  granular  or  fatty. 

In  cases  of  older  standing  the  connective  tissue  has  usually 
undergone  a  marked  increase.  The  capsule  is  thick,  dense  and 
adherent.  The  cortical  substance  is  shrunken  with  a  great  in- 
crease of  the  fibrous  elements,  and  the  same  holds  true  of  the 
medullary  portion.  In  consequence  of  this,  even  in  the  cortical 
substance  the  white  or  gray  color  predominates.  The  parenchy- 
matous tissue  (glomeruli,  tubules)  have  greatly  shrunken.  In 
connection  with  the  contraction  of  the  forming  fibrous  hyper- 
plasia, there  is  a  general  shrinkage  of  the  kidney  in  size,  it  may 
be  to  one-half  its  original  volume.  Trasbot  reports  a  case  of 
nephritis,  of  8  months  standing,  in  the  dog,  with  a  kidney  half  the 
normal  size,  in  the  end  the  parenchyma  may  have  practically 
disappeared,  and  the  kidney  may  have  shrunken  to  a  small,  firm,. 


Chronic  Nephritis,  241 

white,  fibrous  mass.  Abscess  of  the  kidney  is  exceptionally  met 
with  (Laurent,  Lafosse). 

Lesiofis  of  distant  organs  are  not  uncommon.  Bronchitis, 
pneumonia,  pleurisy,  insufficiency  of  the  tricuspid  or  mitral 
valves,  dilated  heart,  hypertrophied  or  fatty  heart,  congested  or 
fibroid  liver,  arteritis,  and  dropsies  are  among  such  morbid  con- 
ditions. 

Prognosis,  This  is  almost  always  unfavorable.  Death  may  be 
delayed  for  months  or  years,  and  partial  transient  recoveries  may 
take  place  but  a  restoration  to  normal  structure  and  function  is 
not  to  be  looked  for. 

Treatment.  This  cannot  be  expected  to  be  much  more  than 
palliative.  The  avoidance  of  overwork,  and  of  the  exposure  to 
cold  and  wet,  and  the  securing  of  a  free  action  of  the  skin  by 
warm  buildings  and  clothing,  are  essential.  The  diet  should  be 
easily  digested  and  non-stimulating,  for  herbivora  gp-een  food,  car- 
rots, roots,  apples,  silage,  with  a  moderate  allowance  of  oats  to 
counteract  weakness  and  anaemia ;  and  for  camivora,  milk,  butter- 
milk, mush  made  of  oat,  wheat  or  barley  meal,  with,  if  necessary, 
a  slight  allowance  of  tender  raw  meat.  Tonics  fill  a  similar  need. 
Iron  and  bitters  may  be  combined.  Or  hydrochloric  acid  or  nitro- 
muriatic  acid  with  bitters  (nux,  calumba,  salicin,  quassia)  may 
be  tried.  These  acids  are  especially  valuable. when  the  case  has 
originated  in  or  is  maintained  by  calculi,  indigestion  or  hepatic 
disorder.  When  the  heart  is  defective  in  tone,  it  may  be  stimu- 
lated by  small  doses  of  digitalis,  strophanthus,  spartein,  cafFein, 
or  nitro-glycerine,  or  to  a  certain  extent  by  strychnia  or  nux. 
These,  however,  must  be  used  with  judgment,  if  it  is  found  that 
they  aggravate  the  case  by  increasing  the  arterial  tension.  In 
those  cases  in  which  there  is  an  excessive  secretion  of  watery 
urine,  the  possible  source  of  this  in  musty  aliment  should  be 
avoided,  and  the  flow  checked  by  nux  vomica,  in  moderate  doses, 
and  bromide  or  iodide  of  potassium  in  full  doses.  When,  on  the 
other  hand,  the  urine  becomes  scanty  and  dense,  the  gp^eat  danger 
of  a  toxic  action  must  be  met  by  agents  that  favor  excretion. 
Pure  water  at  will  is  perhaps  the  least  objectionable  of  such 
agents,  but  potassium  or  sodium  acetate  or  citrate,  or  even  sodium 
chloride,  in  weak  solution,  may  be  given.  In  some  cases  benefit 
will  come  from  a  moderate  use  of  the  balsam  of  copiaba,  or  the 
16 


242  Veterinary  Medicine, 

leaves  of  buchu,  or  piperazine.  which  may  improve  the  tone  of  the 
secretory  elements.  The  most  promptly  effective  of  these  agents  is 
pilocarpin  (FriedbergerandFrohner),  but  it  has  the  serious  draw- 
back of  inducing  profuse  and  dangerous  depletion  and  debility. 
Yet  in  careful  hands,  and  with  good  cardiac  tone,  it  may  often  be 
used  to  advantage. 

Fomentations  over  the  loins,  warm  baths  and  mustard  embro- 
cations, may  at  times  be  beneficial.  Attempts  have  been  made  to 
check  the  hyperplasia  by  the  use  of  arsenic,  mercury  or  the  com- 
pounds of  iodine,  but  their  use  in  such  cases  is  based  on  theory 
rather  than  accomplished  results. 


HYPERTROPHY  OF  THE  KIDNEY. 

Hypertrophy  of  both  kidneys  has  not  been  recorded  in  do- 
mestic animals.  On  the  other  hand  the  extraordinary  develop- 
ment of  one  in  compensation  for  the  loss  or  atrophy  of  the  other 
is  not  uncommon.  In  this  the  organ  follows  the  general  law  of 
adaptation,  seen  in  the  double  symetrical  organs  (testicle,  etc.) 
and  the  more  so  that  its  functional  activity  is  indispensable  to  life. 
Among  causes  are :  blocking  of  an  ureter  by  calculus,  worms, 
neoplasm,  nephritic  abscess,  gangrene,  etc.  The  enlargement 
of  the  remaining  kidney  is  a  vicarious  act  and  essentially  a 
physiological  one. 

If  compensation  is  perfect,  it  may  be  impossible  to  detect  symp- 
toms apart  from  those  of  the  primary  disease. 

Prognosis,  Life  is  endangered  in  case  of  any  subsequent  kid- 
ney disease. 


ATROPHY  OF  THE  KIDNEY. 

Result  of  hyperplasia  of  connective  tissues  and  compression  and  absorp- 
tion of  parenchyma.  Unilateral  or  partial.  Causes  :  chronic  productive  in- 
flammation, calculus  in  tubes,  ureter,  or  pelvis,  tumor,  retention  C3rst,  em- 
bolism. Lesions :  sclerosis  of  kidney,  firmness,  pallor,  anemia,  lack  of 
glomeruli  and  tubules,  cysts,  congenital,  urinous  retention,  colloid.  Symp- 
toms :  reduced  secretion,  palpation  of  kidney.  Treatment :  Prevention  : 
arrest  conditions,  abundance  of  water,  succulent  food,  parasiticides,  opera- 
tion on  cysts,  counteract  nephritis. 

Unlike  hypertrophy,  this  is  constantly  the  result  of  a  patho- 
logical process.  So  long  as  a  normal  functional  activity  of  the 
secreting  elements  is  carried  on,  such  parts  must  maintain  their 
size  and  healthy  characters.  But  with  the  compression  of  such 
secreting  elements  (glomeruli  and  convoluted  tubes)  by  a  hyper- 
plasia of  connective  tissue,  by  pressure  from  without  or  from  the 
damming  back  of  the  urine  in  the  pelvis  and  tubes,  the  secretory 
elements  are  absorbed  and  removed,  and  the  final  result  is  a 
general  atrophy.  If  such  atrophy  appears  in  both  kidneys  at 
once  it  can  only  be  very  partial  in  extent,  as  extreme  atrophy  of 
both,  with  loss  of  their  secretory  function,  would  entail  poisoning 
and  death  from  the  retained  urinary  products.  The  comparative 
frequency  of  the  disease  may  be  inferred  from  the  reports  of  the 
numbers  of  specimens  found  by  Barrier  and  Moussu  in  old  horses 
in  the  dissecting  rooms.  The  latter  observed  a  dozen  cases  in  a 
single  winter,  other  examples  are  recorded  by  Cadeac  (horse), 
Soula  (swine)  and  Trasbot  (in  various  animals). 

Causes,  The  most  common  source  of  the  condition  is  the 
occurrence  of  chronic  productive  inflammation.  The  new 
product  in  such  cases,  if  not  pus,  or  a  growth  that  rapidly  passes 
into  fatty  or  granular  degeneration,  or  into  gangrene,  tends  to 
form  tissue  of  a  low  organization,  especially  fibrous.  The  re- 
sulting increase  of  the  fibrous  trabeculae,  in  undergoing  subse- 
quent contraction  necessarilyjcompresses  the  secretory  tissue  and 
the  final  result  is  a  visible  and,  it  may  be,  extreme  wasting. 
Hence  any  slowly  advancing  productive  inflammation  is  liable 
to  result  in  absorption  and  removal  of  the  kidney  parenchyma, 
and  distinct  atrophy  of  the  gland. 
243 


244  Veterinary  Medicine, 

Again  the  obstruction  of  the  ureter  by  a  calculus  in  the 
pelvis  which  falls  into  the  infundibuliform  entrance,  or  a  stone 
•arrested  at  any  part  of  the  duct  (or  even  of  the  urethra)  or  by 
worms,  hydatids,  cysts  or  tumors,  throws  back  on  the  kidney 
the  secreted  urine,  which  distending  the  pelvis  and  urinifer- 
ous  tubes  leads  to  direct  compression  and  absorption  of  the 
secretory  parenchyma.  Direct  compression  of  the  kidney  by 
an  adjacent  tumor  will  act  in  a  similar  manner.  Retention  cysts 
by  their  gradual  increase  and  augmenting  pressure  cause  ab- 
sorption of  the  gland  tissue. 

The  blocking  of  individual  uriniferous  tubules  by  minute 
calculi,  which  is  so  often  seen  in  cattle,  kept  on  dry  feeding 
in  winter,  is  a  cause  of  partial  nephritis,  and  absorption,  as 
noted  by  Roll. 

A  somewhat  rare  cause  of  atrophy  is  the  diminution  of  the 
blood  supply  by  arteritis  and  embolism  of  the  renal  artery,  or 
by  pressure  of  tumors  on  that  vessel.  Arteritis  and  blocking 
suggests  at  once  the  possible  agency  of  the  strongylus  (sclero- 
stoma)  armatus  in  the  horse.  Trasbot  records  a  striking  instance 
of  compression  of  the  renal  artery  and  kidney  by  an  enormous 
sublumbar  melanoma.  This  occurred  in  an  aged  horse  and 
led  to  atrophy. 

Lesions,  In  cases  due  to  productive  inflammation  with  sclerosis 
of  the  kidney,  the  firmness,  pallor  and  bloodlessness  of  the 
organ  is  a  marked  feature.  When  incised  it  is  found  to  be 
composed  mainly  of  fibrous  tissue,  while  the  glomeruli  and 
tubuli  have  to  a  large  extent  disappeared. 

If  there  has  been  simple  lack  of  circulation  the  kidney  becomes 
flaccid,  pale  and  small  in  size.  The  secretory  elements  (glomer- 
uli and  uriniferous  tubes)  are  first  absorbed,  leaving  the  fibrous 
network,  which  tends  to  shrink  and  form  a  hard  resistant  mass. 
In  extreme  cases  there  may  be  absolutely  no  glandular  tissue  left, 
and  the  dense  shrunken  mass  represents  only  the  hyperplasia  of 
the  original  fibrous  network.  In  the  different  successive  stages 
of  this  process  the  glomeruli  and  tubules  become  flattened,  the 
epithelial  cells  become  granular,  or  contain  colloid  casts  and  re- 
frangent  elements  like  oil  globules  and  finally  they  are  repre- 
sented by  a  small  mass  of  fibrous  material. 

Of  all  the  atrophies  caused  by  the  pressure  of  tumors  perhaps 


Atrophy  of  the  Kidney.  245 

that  caused  by  cysts  is  the  most  characteristic.  There  may  be  a 
single  cyst  or  they  may  be  multiple  ;  they  may  range  in  size  from 
a  pea  to  the  size  of  the  two  fists  the  total  size  exceeding  that  of 
the  normal  kidney.  In  all  such  cases  the  cysts  project  visibly 
from  the  surface  of  the  organ.  They  vary  according  to  their 
origin  and  nature.  Congenital  cysts  are  said  to  have  resulted 
from  distention  by  retained  urine  of  the  capsule  of  the  glomerulus. 
The  arterial  tuft  is  atrophied  and  flattened  against  the  wall. 
Serous  cysts  with  clear  contents  are  found  in  the  old.  Urinous 
cysts  again  form  by  dii^tension  of  the  tubules  that  are  obstructed 
by  cysts  or  minute  calculi.  Colloid  cysts  are  found  in  certain 
forms  of  nephritis  formed  by  the  dilatation  of  the  capsule  of  the 
glomerulus  or  of  the  uriniferous  tubules.  The  liquid  often  con- 
tains leucin,  tyrosin  and  cholesterine.  In  all  such  cases  the  walls 
of  the  cyst  become  thick,  and  the  glandular  parenchyma  is  com- 
pressed leading  to  progressive  degeneration  and  atrophy. 

Symptoms  of  atrophy  of  the  kidney  are  necessarily  those  of 
suppression  of  urine,  with,  in  certain  cases,  the  passage  of  casts  of 
the  uriniferous  tubes  and  of  crystals  of  salts.  There  are,  how- 
ever, no  absolutely  pathognomonic  symptoms.  When  the  kidney 
can  be  reached  through  the  flaccid  walls  of  a  comparatively  empty 
abdomen,  or  through  the  rectum,  its  hard,  shrunken  condition 
may  assist  in  diagnosis. 

Treatment  is  not  successful  in  advanced  cases.  Prevention  is 
to  be  sought  by  obviating  or  treating  the  conditions  on  which  the 
atrophy  depends.  Nephritis  must  be  treated  on  general  principles. 
Calculi  must  be  avoided  by  a  liberal  supply  of  water,  by  soiling, 
or  by  pasturage.  Strongylus  parasitism  should  be  dealt  with  by 
destroying  the  parent  worms  in  the  bowels,  and  by  securing  pure 
drinking  water  free  from  their  eggs  and  embryos.  Cysts,  and 
tumors  are  only  amenable  to  surgical  measures  and  not  often 
open  even  to  these. 


FATTY  DEGENERATION  OF  THE  KIDNEY  :  STEATO- 
SIS OF  THE  KIDNEY. 

Causes :  age.  overfeeding,  idleness,  atony,  retention  of  urine.  Lesions : 
kidney  enlarged,  pale  yellow,  capsule  loose,  cat  surface  glistening  uuctuous, 
oil  globules  in  scrapings,  granules  soluble  in  ether.  Symptoms  :  in  idle, 
overfed,  obese,  imptoved  meat  producing  breeds,  closely  confined,  starchy 
or  saccharine  food,  fatty  granules  in  urine,  finally,  dropsies,an8emia,  debility, 
sluggishness.  Prognosis  unfavorable  in  advanced  stages.  Treatment : 
butcher,  restricted  regimen,  open  air  exercise,  nitrogenous  diet,  crossing, 
diuretic  food  or  drugs,  oil  of  turpentine,  balsam  copiaba.     Palliation  only. 

Fatty  degeneration  of  the  kidneys  is  by  no  means  unknown  in 
the  domestic  animals.  It  has  been  observed  in  dogs  and  cats 
(Rogers,  Goubaux,  Vulpain,  Trasbot).  In  dogs  it  has  been 
erroneously  set  down  as  a  characteristic  lesion  of  rabies.  Like 
fatty  degeneration  of  other  organs,  it  is  also  met  with  in  old 
and  over-fed  individuals  of  meat  producing  breeds  of  animals,  in 
which  the  tendency  to  early  maturity  and  rapid  and  excessive 
fattening  has  been  fostered  from  generation  to  generation.  In 
man  small,  granular,  fatty  kidney  is  a  common  result  of  chronic 
parenchymatous  nephritis,  and  often  coincides  with  fatty  liver. 
Chronic  poisoning  by  arsenic  or  phosphorus  is  another  cause,  as 
it  is  of  fatty  degeneration  in  other  organs. 

Vulpain  has  attributed  it  to  a  lack  of  active  exertion  and  of 
general  tone,  associated  with  excessive  amylaceous  feeding, 
sluggish,  shallow  breathing  and  tardy  elimination.  Goubaux 
and  Trasbot  attach  great  importance  to  the  compulsory  retention 
of  urine  in  house  dogs,  cats  and  horses.  The  damming  back 
of  the  urine  in  the  convoluted  tubes  and  glomeruli,  temporarily 
arrests  secretion,  and  the  inactive  and  compressed  cells  tend 
at  once  to  granular  and  fatty  degeneration. 

Lesions,  The  gland  is  sensibly  increased  in  size,  and  pale 
yellowish  or  straw  yellow.  The  capsule  is  easily  detached  from 
the  cortical  substance,  contrary  to  what  is  the  case  in  chronic  pro- 
ductive inflammation.  The  cortical  substance  is  increased  in 
thickness,  and  pale,  the  pallor  being  largely  in  ratio  with  the  du- 
ration or  extent  of  the  fatty  degeneration.  The  cut  surface  may 
be  glistening  and  unctuous  to  the  touch.  It  is  softer  than  usual, 
246 


Fatty  Degeneration  of  the  Kidney,  247 

rather  friable,  and  if  scraped,  furnishes  a  serous  or  grayish  pulp 
in  which  oil  globules  are  prominent  features,  together  with  gran- 
ular epithelium  and  free  granules  that  dissolve  readily  in  ether. 
Tubules  are  varicose  and  unequal  at  different  parts.  The  medul- 
lary portion  has  undergone  little  change.  It  may  be  paler  at  cer- 
tain points,  with  some  shrinking  of  its  substance  and  increase  of 
firmness. 

Symptoms,  As  a  rule  the  disease  occurs  in  pampered,  overfed 
and  obese  animals,  and  in  those  of  the  improved  breeds  which 
have  great  power  of  digestion,  assimilation  and  fattening.  It  is 
especially  to  be  looked  for  after  close  confinement  on  full,  stimu- 
lating, amylaceous  diet.  Symptoms  are  not  usually  recognized 
during  life.  There  is,  however,  a  lessening  of  the  urinary  secre- 
tion, and,  as  the  disease  advances,  albuminuria.  When  ex- 
amined microscopically  this  is  found  to  contain  characteristic  ele- 
ments, such  as  granular  epithelial  cells,  the  granules  soluble  in 
ether,  oil  globules,  and  at  times  crystals  of  cholesterine  (Beale). 
A  diagnosis  based  on  the  mere  presence  of  oil  globules  may,  how- 
ever, be  fallacious,  as  these  may  be  present  in  animals  that  have 
just  been  heavily  fed  on  oleaginous  food,  and  again  the  oil  used 
to  smear  the  catheter  may  float  in  the  urine  and  prove  misleading. 
Under  such  circumstances  vaseline  or  glycerine  may  be  substi- 
tuted on  the  catheter.  Scriba  induced  fatty  urine  by  injecting 
fat  or  oil  emulsion  into  the  blood,  and  Chabrie  by  ligating  the 
large  intestine.  Trasbot  says  that  cylindroid  casts  may  be 
present.  As  in  other  grave  kidney  affections,  dropsies  supervene 
as  the  disease  advances.  These  may  show  in  the  limbs,  in  the 
abdomen,  or  in  other  serous  cavities.  A  steadily  advancing 
anaemia  with  pallor  of  the  mucosae,  listlessness,  weakness,  debility 
and  sluggishness  are  to  be  noted. 

Prognosis,  Since  the  disease  is  rarely  diagnosed  until  it  has 
reached  an  advanced  stage,  it  usqally  progresses  steadily  to  a  fatal 
issue.  If,  however,  it  can  be  detected  at  an  earlier  stage,  it  may 
be  palliated,  or  held  in  abeyance,  for  a  length  of  time  varying 
with  the  extent  of  the  lesions.  As  it  is  very  largely  a  disease  of 
meat  producing  animals  and  as  the  subject  is  at  first  in  a  condition 
of  marked  obesity,  it  can  usually  be  turned  over  to  the  butcher 
without  material  loss. 

Treatment,     If  the  disease  has  resulted  from  the  inbred  pro- 


248  Veterinary  Medicine, 

pensity  to  fattening,  the  family  that  shows  the  disposition  must 
be  subjected  to  a  somewhat  different  regimen,  open  air  exercise 
must  take  the  place  of  confinement  in  warm  stables,  a  rather  bare 
pasturage  is  valuable  for  herbivora,  and  restricted  diet  in  which 
the  oleaginous,  saccharine,  and  amylaceous  constituents  do  not 
predominate,  is  strongly  indicated.  Crossing  with  a  strange  male 
having  many  of  the  desirable  qualities  of  the  herd,  but  which  is 
more  vigorous  may  be  resorted  to.  When  the  secretion  of  urine 
becomes  scanty  an  abundance  of  pure  water,  or  a  diet  of  succu- 
lent grass  or  roots  or  ensilage  or  even  small  doses  of  alkaline 
diuretics  may  be  resorted  to.  Any  source  of  arsenic  or  phosphorus 
poisoning  should  be  cut  off,  and  as  an  antidote  to  phosphorus, 
oil  of  turpentine  may  be  given  in  small  doses.  This  agent  may, 
indeed,  replace  the  alkalies  as  a  diuretic,  bringing  in  an  element 
of  tone  for  the  mucosa  which  is  not  to  be  despised.  Or  balsam  of 
copiaba  or  buchu  leaves  may  be  substituted. 

When  the  small  white  kidney  (granular,  fatty)  results  from 
chronic  nephritis,  the  prevention  and  treatment  would  be  as  for 
that  disease.  Little  hope  is  to  be  entertained  of  entire  restoration 
to  health. 


AMYLOID  KIDNEY.  LARDACEOUS  OR  WAXY  KIDNEY. 

This  condition  of  the  kidney  has  been  found  in  the  ox  (Ger- 
lach)  and  dog  (Rabe,  etc. ) .  There  are  commonly  similar  degenera- 
tive lesions  in  the  liver,  pancreas,  intestines  and  other  organs.  It  is 
usually  a  concomitant  of  some  chronic  wasting  disease  (chronic 
nephritis,  tuberculosis,  etc.). 

Morbid  Anatomy.  The  kidney  is  usually  enlarged,  pale  and  on 
section  waxy  or  glistening.  Soaked  in  dilute  compound  tincture 
of  iodine  it  shows  spots  of  a  walnut  or  mahogany  brown  color. 
The  glomeruli  are  well  marked  and  show  the  earlier  changes, 
later  the  tubes  do  so  excepting  the  epithelium.  The  latter  is 
swollen,  granular,  fatty. 

Symptoms.  There  may  have  been  those  of  chronic  nephritis. 
Rabe  has  noticed  in  dogs  dropsy  of  the  limbs,  ascites,  emaciation, 
anorexia,  followed  by  uraemia,  coma,  weakness,  vomiting,  and  if 
the  kidney  alone  was  affected  great  lowering  of  temperature 


Renal  Calculus,  249 

(35-9^  C).  With  hepatic  complication  there  was  greater  weak- 
ness, giddiness,  and  higher  temperature  ( 39. 6®  C ) .  Urine  is  com- 
monly increased  (in  man  albuminous)  and  the  casts  have  shown 
the  amyloid  reaction.  They  tend  to  be  fatty  or  finely  granular. 
Casts  may,  however,  show  amyloid  reaction  when  the  kidney, 
post-mortem,  does  not  (Jaksch). 

Diagnosis  from  Bright's  disease  is  often  impossible. 

Treatment  is  essentially  the  same  as  in  chronic  nephritis,  and  is 
not  hopeful. 

Trasbot  recommends  KI  3  to  7  grs. ,  or  tinct  of  iodine  3  drops 
for  shepherd  dog.  Ol.  terebinth  and  alkaline  diuretics  are  also 
commended. 


RENAL  CALCULUS. 

This  is  much  more  common  than  is  supposed.  Small  calculi 
formed  in  the  tubuli  uriniferi  of  cattle  on  dry  winter  feeding  often 
pass  without  recognition,  and  habitually  disappear  on  rich  spring 
and  summer  grass. 

If  retained  in  the  pelvis  until  increasing  size  forbids  their  pas- 
sage through  the  ureter  they  form  pelvic  calculi. 

If  retained  in  the  bladder  so  that  they  cannot  enter  the  urethra 
they  form  cystic  calculi. 

Pelvic  calculi  or  concretions  are  often  (in  cattle  and  swine)  mere 
scales  l3dng  in  chalices.  They  may  fill  the  whole  pelvis  and  send 
branching  processes  into  chalices. 

Causes,  They  are  attributed  to  phosphaturia,  lithaemia  or  uric 
acid  diathesis,  oxaluria,  etc.  In  cattle  they  are  associated  with  dry 
feeding  and  are  common  on  all  magnesian  limestone  soils.  There 
are  usually  catarrh  of  the  kidney  and  the  presence  of  bacterial  fer- 
ments and  colloids  (pus,  albumen,  etc.).  (Sharing  and  Ord.) 
Calculi  or  gravel  is  preceded  by  renal  catarrh,  but  this  is  aggra- 
vated by  the  crystalline  deposit.  Bacteria  act  also  in  producing 
NH,0,  which  instantly  precipitates  ammonio-magnesian  phos- 
phate.    Retention  of  urine  greatly  favors  the  precipitation. 

Symptoms,  A  white  or  brownish  yellow  deposit  in  the  last  urine 
discharged  collects  on  the  floor.  Cloudy  urine.  Passage  of  crys- 
tals— round— or  angular.     Colic.     Lameness  in  one  or  both  hind 


250  Veterinary  Medicine. 

limbs.  Arched  back.  Sensitive  loins.  Pain  paroxysmal.  Attempts 
to  urinate.  Little  passed  but  often  with  drops  of  blood.  Sudden 
relief  when  the  calculus  enters  the  bladder. 

Retained  in  the  kidney  it  may  cause  no  suffering  in  meat  pro- 
ducing animals,  but  in  horses  it  usually  causes  stiffness  or  lame- 
ness especially  under  violent  effort.  Also  hematuria  ;  blood  glob- 
ules are  found  in  the  deposit  when  placed  under  the  microscope. 
There  may  be  sepsis  and  specially  cloudy  offensive  urine. 

Diagnosis  :  May  be  confounded  with  renal  tuberculosis,  or  sar- 
coma or  oxaluria.  Examine  for  bacillus,  small  cells,  or  oxalate  of 
lime  or  oxalic  acid. 

Prophylaxis,  In  the  early  stages  give  succulent,  watery  food, 
ensilage,  roots,  potatoes,  spring  grass,  and  water  ad  libitum. 

Treatment,  Salt  may  tempt  the  patient  to  drink.  Nitro-muri- 
atic  acid  is  a  solvent  and  antiseptic.  Or  alkalies  with  salicylate 
of  soda.  Also  tonics.  Quiet  pain  by  morphia  and  other  anodynes. 
Use  piperazine. 

These  failing,  an  operation  on  the  kidney  may  be  considered. 

HYDRO-NEPHROSIS. 

A  common  result  of  calculus  or  other  obstruction,  causing  in- 
creasing pressure  of  urine  in  the  pelvis  and  absorption  of  the 
parenchyma,  and  finally  leaving  a  mere  urinous  sac. 

RENAL  TUMORS. 

1.  Non-malignant:  Fibroma. 

Lipoma. 
Angioma. 
Adenoma. 
Papilloma. 

2.  Malignant :  Sarcoma. 

Carcinoma. 

RENAL  PARASITES. 

Echinococcus :  Herbivora,  Omnivora. 
Bilharzia  Crassa  :  Egyptian  cattle. 
Strongylus  Gigas :  Horse,  ox,  dog,  man. 
(Cysticercus  TenuicoUis  :  Ruminants:  Pig). 
Taenia  serrata  :  Dog.     Pelvis. 


Injuries  of  the  Ureters,  251 

Sclerostoma  equinum  :  (renal  arteries,  ^'^ifw^/^/m),  soliped. 

Stepbanurus  dentatus  :  Pig,  (pus  cavities). 

Trichosoma  plicata  :  (Urinary  bladder),  dog. 

T.  felis  :  (Cat),  bladder. 

Indetermined  embryos  :  Kidney,  dog  ;  small  tumors. 

Cytodites  nudus  :  Kidneys  ;  bens. 

CBstrus,  (Gast.  Hemorrhoidalis)  :  Bladder  walls  ;  borse. 

Mucorimyces  :  Kidneys  ;  dog. 

Coccidia  :  Kidney,  Horse,  dog.  goose. 


INJURIES  OF  THE  URETERS. 

Lesious  by  bullets,  arrows,  stabs,  bruises  and  lacerations  in  parturition, 
treads,  wheels,  tumors,  ulcers,  calculi,  tubercles,  parasites.  Course. 
Pathology  :  transverse  division  may  cause  hydronephrosis,  or  septic  peri- 
tonitis. Symptoms  :  uncertain,  traumatism,  bloody  urine,  arched,  stiffs 
tender  loins,  straining,  recumbency,  groaning  in  turning  or  rising,  rectal 
palpation  of  distended  ureter,  of  ascitic  fluid,  pitting  on  pressure  of  loin, 
flank  or  f^roin,  liquid  drawn  through  a  cannula  is  urinous,  urine  still  dis- 
charged by  normal  channel.  Crystals  in  urine,  worm  ova.  Treatment : 
compresses,  fomentations,  sinapisms,  anodynes,  balsams,  antispasmodics, 
extraction  of  calculus,  lateral  implantation  of  urethra. 

From  tbeir  deep  and  protected  position  it  might  be  plausibly 
concluded  tbat  tbe  ureters  were  secure  against  every  kind  of 
traumatism.  This  however,  is  not  tbe  case,  since  in  botb  man 
and  animals  tbey  bave  been  known  to  bave  been  injured  by 
bullet  wounds,  arrow  wounds,  and  stab  wounds  of  various  kinds. 
In  distokia  with  laceration  of  tbe  womb,  vagina  or  bladder  tbe 
ureter  is  liable  to  be  injured.  By  blows  and  kicks  it  may  even 
be  ruptured  or  torn  across,  and  also  by  sudden  and  severe  me- 
chanical compression  of  tbe  abdomen  as  when  run  over  by  a 
wagon  or  trodden  on  by  a  borse,  ox,  or  other  large  animal.  Tu- 
mors of  various  kinds  may  grow  in,  or  press  upon  the  ureter, 
ulcers  with  thick  indurated  margins  or  base  may  obstruct  the 
passage,  or  calculi,  or  worms  may  block  and  give  rise  to  over- 
distension and  even  rupture.  Kopp  describes  obstruction  by 
multiple  calculi  with  saccular  dilation  in  front,  close  to  the  kidney 
in  a  cow.     Cadiot  records  cases  of  thickening  of  the  mucosa  by 


252  Veterinary  Medicine, 

numerous  cysts  as  small  as  bempseed .  Intra-abdominal  tumors  of 
tbe  spermatic  cord  bave  been  known  to  block  tbe  passage.  Again 
tubercles  bave  formed  on  tbe  uretbra,  and  polypi  on  tbe  trig- 
onum  vesicae  bave  blocked  tbe  ureter  and  produced  all  tbe  evil 
consequences  of  calculus,  parasites,  etc. 

Course, .  Tbe  progress  of  tbe  disease  will  vary  greatly  according 
to  tbe  nature  of  tbe  lesion.  Witb  complete  rupture  of  tbe  ureter 
tbe  urine  as  a  rule  escapes  into  tbe  peritoneal  cavity.  If  tbe 
urine  is  aseptic  tbis  may  not  lead  to  serious  results  and  tbe  edges 
of  tbe  wound  cicatrizing,  tbe  urine  is  imprisoned  in  tbe  tfreter 
and  pelvis  of  tbe  kidney,  and  leads  to  final  atropby  of  tbe  kidney 
and  bydro-nepbrosis.  Wben  on  tbe  otber  band  infecting  matter 
escapes  witb  tbe  urine,  as  in  perforating  ulcer,  tubercle,  glanders, 
cancer,  infective  catarrb  of  tbe  kidneys  or  ureter,  sucb  infection 
is  brougbt  in  contact  witb  tbe  wbole  peritoneal  surface,  wbere 
secondary  infections  follow.  In  cases  associated  witb  penetrating 
wounds,  wounds  resulting  from  dystokia,  calculous  or  parasitic 
obstruction,  similar  infection  is  to  be  dreaded. 

Tbe  symptoms  are  by  no  means  clear,  unless  tbe  injury  result 
from  external  traumatism,  or  wben  it  can  be  detected  by  rectal 
exploration.  Tbere  may  be  blood  staining  of  tbe  urine,  stifiFness 
of  tbe  loins,  lameness  in  one  bind  limb,  tenderness  of  tbe  lumbar 
vertebrae  and  of  tbeir  tranverse  processes  on  pincbing.  frequent 
straining  to  pass  urine,  a  disposition  to  remain  recumbent,  pain 
and  groaning  wben  rising,  or  wben  turned  in  a  narrow  circle. 
Under  rectal  examination  tbe  blocked  ureter  may  sometimes  be 
recognized,  its  cystic  end  sbrunken  and  empty,  up  to  tbe  seat  of 
obstruction,  and  its  renal  end,  from  tbe  bypersensitive  seat  of  ob- 
struction forward,  full,  rounded,  elastic  and  firm.  If  tbe  ureter  bas 
been  ruptured,  it  may  be  impossible  to  distinguisb  it,  but  tbe 
presence  of  urine  free  in  tbe  peritoneum  may  be  detected  tbrougb 
tbe  rectum  as  it  may  often  be  tbrougb  tbe  abdominal  walls. 
Sometimes  tbe  urine  infiltrates  tbe  subperitoneal  connective  tissue, 
and  forms  a  pasty  swelling  on  tbe  loin  or  flank.  In  eitber  case  a 
bollow  needle  inserted  will  draw  off  a  liquid  baving  an  urinous 
odor.  Tbat  tbis  urine  bas  escaped  in  front  of  tbe  bladder  may  be 
safely  inferred  from  tbe  continued  discbarge  of  urine  by  tbe 
uretbra  and  by  tbe  absence  of  cystic  swelling,  beat  and  tender- 
ness.    If  tbe  kidney  can  be  reacbed  by  rectal  exploration  it  is 


Injuries  of  the  Ureters.  253 

felt  to  be  firm  and  resistant  up  to  the  period  of  rupture  of  the 
ureter. 

In  case  of  obstruction  by  calculus,  crystals  and  even  small  cal- 
culi may  be  passed  in  the  urine,  there  is  usually  a  history  of 
previous  attacks  of  renal  colic,  and  the  suffering  is  manifestly  ex- 
treme. In  case  of  worms  (strongyjius  gigas)  the  use  of  the  cen- 
trifuge on  the  urine,  may  possibly  secure  in  the  sediment  speci- 
mens of  its  ova.  The  existence  of  tumors  or  tubercles  can  usually 
be  clearly  made  out. 

Treatment  will  be  as  varied  as  the  lesion.  Simple  ureteritis 
may  be  met  by  wet  compresses,  sinapisms,  and  internally  by  bal- 
sams and  anodynes.  Calculi  and  parasites  may  be  passed  with 
some  aid  perhaps  from  fomentations,  antispasmodics,  and  diluents. 
Obstinate  cases  can  only  be  successfully  met  by  surgical  interfer- 
ence. .  The  resulting  wounds  in  the  ureter,  like  ruptures,  perfor- 
ating ulcers  and  strictures  may  be  met  by  Van  Hook's  ''lateral 
implantation ' '  /  the  divided  cystic  end  of  the  ureter  is  ligatured 
and  on  the  cystic  side  of  the  ligature  a  longitudinal  incision  is 
made,  large  enough  to  admit  the  divided  extremity  of  the  renal 
portion,  and  through  each  of  the  two  sides  of  this  last  a  fine  liga- 
ture is  passed  ;  these  ligatures  are  then  passed  into  the  lumen  of 
the  cystic  portion  of  the  ureter  through  its  longitudinal  incision 
and  brought  outward  through  its  walls  ;  next  the  renal  end  is  in- 
serted into  the  incision  in  the  cystic  end  and  the  two  are  firmly 
sewed  together  by  the  two  ligatures.  ,  When  a  small  portion  of  an 
ureter  must  be  excised  it  may  sometimes  be  possible  to  save  a  val-  ' 
uable  animal  by  such  an  expedient. 

In  some  cases  of  rupture  into  the  vagina  or  uterus  an  available 
fistula  may  sometimes  be  established  into  one  of  these. 


URETERITIS. 

Prom  wounds,  calculus,  parasites,  infection,  injuries  in  parturition. 
Symptoms  :  in  wounds  of  ureter.  Course  :  danger  of  infection  of  kidney  or 
bladder.  Treatment :  for  calculus,  antispasmodics,  anodynes,  fomentations ; 
for  pardsites,  arsenious  acid ;  for  catarrhal  conditions,  balsams,  buchu, 
salicylates,  etc.    Operation.     Uretero-vaginal  fistula. 

This  may  arise  from  the  passage  of  a  rough  calculus,  from 
wounds  of  the  ureter  sustained  in  kicks  and  blows  or  by  being  run 
over  by  wheels  (dogs,  cats),  it  may  be  due  to  the  blocking  of  the 
tube  by  a  parasite  such  as  strongylus  gigas,  ecchinococcus,  etc.,  or 
it  may  be  the  result  of  extension  of  an  infectious  inflammation 
backward  from  the  kidney  or  forward  from  the  bladder.  Again 
it  may  be  the  result  of  a  lesion  of  the  ureter  in  cases  of  dystokia. 

The  symptoms  are  obscure  but  there  is  likely  to  be  frequent 
straining  and  passage  of  urine,  tenderness  of  the  loins,  all  the 
more  significant  if  confined  to  one  side,  lameness  or  halting  on 
the  corresponding  hind  limb,  and  on  examination  through  the 
rectum  the  swollen  and  tender  cord  representing  the  ureter  may 
be  recognizable.  In  case  of  calculus  or  other  obstruction  the 
ureter  may  be  felt  to  be  swollen,  elastic  and  tender  back  to  a 
slight  nodular,  painful,  firm  swelling  at  the  seat  of  obstruction. 

Course,  In  all  such  cases  there  is  always  danger  of  inflamma- 
tion (infectious  or  otherwise)  of  the  kidney  with  degeneration 
and  loss  of  structure  and  function,  the  organ  being  reduced  to  a 
simple  urinous  cyst  (hydronephrosis).  In  some  cases,  however, 
the  obstruction  (calculus,  parasite)  may  escape  into  the  bladder 
and  a  recovery  follow.  Slight  infections,  too,  may  improve  and 
advance  to  complete  convalescence. 

Treatment  will  depend  much  on  the  causative  factor :  Calculus 
must  be  treated  by  anodyne  anti-spasmodics,  and  fomentations, 
and  in  case  of  relief  by  measures  calculated  to  prevent  its  forma- 
tion anew  :  parasites  may  be  treated  by  arsenious  acid ,  oil  of  turpen- 
tine, and  other  parasiticides  which  are  secreted  by  the  kidneys  : 
catarrhal  and  infected  conditions  may  be  met  by  balsams,  buchu, 
salicylic  acid,  piperazine,  and  even  peppers.  In  case  of  calculus 
which  does  not  give  promise  of  passing,  even  a  surgical  opera- 
tion may  be  thought  of,  especially  in  the  smaller  house  animals. 
254 


Acute  Catarrhal  Cystitis,  255 

In  rupture  of  the  ureter  in  dystokia  the  walls  of  the  womb  or 
vagina  have  usually  suflFered,  and  a  recovery  with  a  uretero- 
aterine  or  uretero-vaginal  fistula  is  not  unknown. 


ACUTE  CATARRHAL  CYSTITIS. 

Acrid  diuretics,  by  month  or  skin,  microbian  inrection,  retention  of  urine, 
urethral  calculus,  parasites,  spasm,  enforced  suspension  of  micturition,  un- 
•clean  catheter,  adjacent  infection,  chill.  Lesions :  hypersemia  of  mucosa, 
thickening,  vascular  distention,  clouding  of  epithelium,  muco-purulent  se- 
-cretion,  alkaline  fermentation,  ammonia  liquefaction  of  cells,  erosion. 
Symptoms :  Slight  fever,  stiff,  straddling  gait,  urine  scanty,  cloudy,  alka- 
line, penis  or  clitoris  semi-erect,  smearing  of  tail  or  prepuce.  Crystals  of 
triple  phosphate.  Treatment :  Antiseptics,  boric  or  salicylic  acid,  gum 
arable,  astringent,  antiseptics,  laxatives,  flax  seed,  slippery  elm,  anodynes, 
diluents,  piperazine,  drainage  rest,  restricted  laxative  diet,  warmth,  avoid 
stimulants. 

Causes.  Cystitis  is  caused  in  all  animals  by  irritant  diuretics 
like  cantharides,  copaiba,  or  oil  of  turpentine  given  by  the  mouth 
or  applied  to  an  extensive  cutaneous  surface.  It  is  an  error,  how- 
ever, to  conclude  with  Williams  that  this  is  the  sole  cause.  The 
very  existence  of  calculi  virtually  implies  bacterial  infection,  and 
fermentation.  The  presence  of  free  ammonia  in  the  urine  usually 
implies  fermentation,  and  fermentation  must  be  looked  upon  as 
practically  synonymous  with  microbian  invasion.  That  bacteria 
may  be  present  without  serious  injury  is  undoubted.  The  pro- 
tective power  of  the  healthy  mucosa  is  very  great.  But  when  the 
mucosa  iy  weakened,  microbes  that  would  otherwise  be  harmless, 
find  a  ready  infection-atrium,  and  triumph  over  the  weakened 
tissues.  Hence  retention  of  urine  and  overdistension  of  the  blad- 
der as  in  urethral  calculus,  blocking  of  the  urethra  by  a  parasite, 
spasm  of  the  sphincter  vesicae,  compulsory  retention  as  in  the 
mare  in  harness,  the  dog  kept  indoors,  or  in  railway  car  on  a 
long  journey,  or  in  mares  so  travelling,  may  become  the  occasion 
of  cystitis.  Even  in  cases  in  which  no  microbe  is  present  at  first, 
this  reaches  the  bladder  by  the  introduction  of  an  unclean  cathe- 
ter, or  by  extension  from  an  uretheritis,  vaginitis  or  metritis,  or 
^even  from  a  peritonitis,  or  infected  urachus.     Or  the  infection 


256  Veterinary  Medicine. 

may  descend  from  a  suppurating  kidney.  Another  occasion  of 
microbian  invasion  is  the  congestion  which  attends  on  exposure 
to  cold. 

Lesions.  H3rperaemia  of  the  cystic  mucosa,  with  dilation  and 
tortuous  deviations  of  the  larger  vessels,  thickening  of  the  mem- 
brane, and  distension  and  clouding  of  the  epithelial  cells,  with  a 
thick  covering  of  tenacious  mucus  containing  epithelial,  pus,  or 
white  blood  cells.  As  the  disease  advances  epithelium  is  desqua- 
mated abundantly,  and  degenerates  with  production  of  free  nuclei 
and  pus.  Along  with  these  are  microbes,  usually  the  bacillus  coli 
communis,  and  various  cocci.  In  the  fully  established  disease 
there  is  liable  to  be  alkaline  fermentation,  and  the  liberated  am- 
monia dissolves  the  epithelial  cells,  leading  to  extensive  desqua> 
mation  and  raw  granulating  surfaces,  so  that  the  malady  tends  to 
run  in  a  vitiating  circle,  the  alkali  dissolving  the  epithelium  and 
increasing  the  microbian  development  and  fermentation,  which  in 
its  turn  produces  an  increasing  quantity  of  ammonia. 

Symptoms.  There  is  slight  hyperthermia  or  none,  stifiF  or  strad- 
dling gait,  frequent  passage  of  urine  in  small  quantities  and 
cloudy,  or  straining  without  passage,  the  penis  or  clitoris  is  semi- 
erect,  eversion  of  the  lips  of  the  vulva  is  frequent,  and  the  blad- 
der is  tender  (through  prepubian  wall,  vagina  or  rectum).  If  a 
finger  is  inserted  into  the  bladder  in  the  mare  the  thickening  of 
the  walls  can  often  be  recognized.  The  urine  often  contains  pre- 
cipitated crystals  of  ammonio-magnesian  phosphate,  and  even 
clots  of  blood.     It  has  an  alkaline  reaction  even  in  herbivora. 

Treatment.  The  danger  centres  around  the  bacteridian  fermen- 
tations, and  a  main  object  must  be  to  disinfect  the  bladder.  This 
will  be  all  the  more  effectual  if  the  lotions  used  are  of  an  acid  re- 
action. Thus  boric  acid  or  salicylic  acid  in  3  per  cent,  solution, 
injected  after  evacuation  of  the  bladder  and  repeated  a  number  of 
times  a  day  may  soon  establish  a  healthy  action.  If  the  bladder 
is  especially  irritable  a  boiled  weak  solution  of  gum  arabic  will 
form  a  suitable  medium.  Other  antiseptics  are  often  used  as 
creosote  (0.5  :  100),  carbolic  acid  (3  :  100),  chloride  of  zinc 
(3  :  100),  chlorate  of  potash  (3 :  100),  mercuric  chloride  ( i :  5000), 
silver  nitrate  (0.5  :  100),  or  astringents  are  often  better  :  PbA, 
Zn  S  O4  tannic  acid,  ferri  chloridi  in  dilute  solution  so  as  not  to 
cause  pain. 


Acute  Croupous  Cystitis,  257 

The  bowels  should  be  kept  open  by  an  occasional  saline  laxa- 
tive, pain  moderated  by  codeine,  and  abundance  of  pure  water 
and  a  laxative  diet  enjoined.  Linseed  tea,  and  infusions  of  slip- 
pery elm  or  marsh  mallow  have  long  been  employed,  and  by 
soothing  and  relaxing  the  bowels  they  act  favorably  on  the 
urinary  mucosa.  Stimulants  of  the  urinary  track  like  buchu, 
uva  ursi  or  copaiba  in  small  doses,  or  antiseptics  like  creosote, 
boric  acid,  salicylic  acid,  peperazine,  are  available  in  slight  cases  or 
when  the  acute  symptoms  have  subsided  somewhat.  With  prior 
infection  of  the  kidneys,  the  latter  may  be  used.  Constant  drain- 
age may  be  necessary  to  avoid  distension. 

Perfect  rest  is  absolutely  essential,  a  restricted  laxative  diet, 
and  a  careful  avoidance  of  cold,  and  stimulants. 

When  urine  is  retained  it  should  be  removed  with  a  thoroughly 
asceptic  catheter. 

In  case  of  blood  clots  in  the  bladder,  wash  out  with  a  boiled 
normal  salt  solution. 


ACUTE  CROUPOUS  CYSTITIS. 

This  has  been  found  to  follow  the  use  of  cantharides  and  other 
irritant  diuretics,  and  to  follow  on  certain  specific  diseases.  Its 
nature  is  that  of  catarrhal  inflammation,  but  with  a  fibrinous 
product  or  false  membrane  formed  more  or  less  extensively  on  the 
inflamed  mucosa. 

Symptoms  are  essentially  those  of  catarrhal  cystitis  from  which 
it  is  distinguished  by  the  presence  in  the  urine  of  flakes  of  the 
fibrinous  membrane. 

Treatment  is  essentially  the  same  as  in  the  catarrhal  form,  to 
which  may  be  added  the  injection  of  a  solution  of  4  grains  scale 
pepsin  to  the  ounce  of  sterilized  water.  The  boric  acid  solution 
may  be  of  the  strength  of  20  per  cent.  Irrigate  two  or  three 
times  a  day. 
17 


CHRONIC  CATARRHAL  CYSTITIS. 

This  may  begin  as  a  mild  attack  or  it  may  continue  after  an 
acute  one.     It  has  been  noticed  in  horse,  ox,  and  dog. 

It  may  be  associated  with  calculi,  gravel,  papilloma,  and  bac- 
terial invasion  especially  by  the  colon  bacillus. 

Lesions.  Mucosa  and  muscular  coat  are  thickened,  corru- 
gated, puckered  and  contracted  so  that  the  bladder  will  not  con- 
tain more  than  a  few  ounces  of  urine.  The  surface  of  the  mucosa 
is  discolored,  mottled  and  variegated,  slaty  blue,  brown,  red, 
purple,  or  even  black,  with  ulcers,  encrustations  of  triple  phos- 
phate, and  fungoid  elevations.  In  dogs  especially,  the  prostate 
is  often  enlarged. 

Symptoms,  Frequent  urination  accomplished  with  pain,  groan- 
ing, or  whining  and  it  may  be  with  sudden  arrest.  There  may 
be  incontinence,  the  urine  dribbling  almost  continuously  from 
the  penis  or  vulva  and  in  the  latter  case  trickling  down  the  thighs. 
The  presence  of  pus  and  mucus  tends  to  mat  the  hairs,  and  a 
strong  urinous  and  ammoniacal  odor  is  emitted. 

Palpation  of  the  prepubian  region  often,  and  of  the  vagina  or 
rectum  always  causes  pain  and  wincing.     Temperature  is  normal. 

Urine  is  albuminous  in  ratio  to  the  amount  of  pus,  or  above 
that,  and  is  then  suggestive  of  kidney  disease  and  likely  to  be 
complicated  by  casts. 

Complicating  lesions  of  the  womb,  vagina,  prostate,  and  kid- 
ney are  to  be  carefully  looked  for,  also  cystic  papilloma. 

Prognosis,  Recovery  though  not  uncommon  is  too  often  but 
partial  and  it  is  usually  desirable  to  fatten  the  animal. 

Treatment,  Rest,  moderate  laxative  diet,  pure  drinking  water 
ad  libitum,  warmth,  antiseptic  irrigation. 


258 


CYSTITIS  IN  THE  OX. 

Special  Symptoms,  Beside  general  disorder  there  is  a  dis- 
position to  decubitus,  but  with  frequent  rising  to  urinate  though 
the  bladder  is  not  filled  to  repletion.  Then  the  urine  is  passed 
in  a  slow  stream  by  abdominal  contraction,  and  without  pulsating 
contractions  of  the  urethra  at  the  ischium  which  are  so  marked 
in  calculus.  Cystitis  is  greatly  aggravated  by  overdistension, 
and  if  the  bladder  is  paralyzed  is  very  liable  to  go  on  to  rupture. 

Galtier  considers  enzootic  haematuria  as  essentially  a  haemor- 
rhagic  cystitis,  due  to  marshy  soils,  disordered  liver,  often  dis- 
tomatosis,  and  irritation  of  the  urinary  organs  by  the  poisons 
which  the  liver  was  helpless  to  destroy  or  eliminate. 

The  treatment  of  cystitis  in  cattle  does  not  difiFer  materially 
from  that  of  the  horse. 

The  haemorrhagic  form  demands  prevention  by  drainage,  cul- 
tivation and  the  use  of  phosphates  to  the  soil. 


CYSTITIS  IN  DOGS. 

The  special  symptoms  in  dogs  are  uneasiness  and  frequent 
changes  of  place.  The  patient  passes  urine  often  in  small  quan- 
tity, and  with  whines  or  cries.  He  walks  slowly  and  stiffly  with 
the  back  arched,  and  compression  of  the  abdomen  and  especially 
of  the  prepubian  region  is  painful  to  a  marked  degree.  The  tense 
elastic  bladder  may  often  be  distinctly  felt  through  the  abdominal 
walls.  The  inflamed  bladder  is  liable  to  paresis  and  paralysis 
with  great  overdistension,  and  aggravation  of  the  general  symp- 
toms, the  eyes  sunken,  and  dullness,  stupor  and  coma  betraying 
uraemic  poisoning.  Some  claim  rupture  of  the  bladder  as  is  so 
common  in  the  ox. 

In  the  main,  treatment  is  as  for  the  horse.     Rest,  warm  bath, 

or  fomentations,  catheterism  with  aseptic  catheter,  draw  urine 

through  hypodermic  nozzle  in  prepubian  region.     Antiseptics  : 

boric  or  salicylic  acid  by  the  mouth  and  bladder.     Laxatives,  and 

259 


26o  Veterinary  Medicine, 

plenty  of  water  are  important.  Free  access  to  open  air  where 
the  animal  can  urinate,  is  very  essential.  In  chronic  cases, 
buchu,  copaiba,  balsams,  or  piperazine  may  be  employed.  Mus- 
tard blister.  Electricity.  Small  doses  of  belladonna  to  give  tone 
to  the  bladder. 


ATONY  AND-  PARALYSIS  OF  THE  BLADDER. 

Causes,  This  comes  usually  from  troubles  of  innervation. 
Paraplegia,  dorsal  and  lumbar  fractures  with  injury  to  the  spinal 
cord,  brain  lesions,  haemoglobinuria  with  effusion  pressing  on 
the  cystic  plexus,  overdistension  of  the  viscus,  from  cervical 
spasm,  urethral  stricture  or  calculus  or  parasite  (strongylusgigas), 
acute  or  chronic  cystitis.  In  dogs  it  may  come  from  obstruction 
by  enlarged  prostate.  Polypus  blocking  the  cervix  and  chronic 
disease  of  the  walls  of  the  organ  are  additional  causes. 

Symptoms,  More  or  less  complete  retention  of  the  urine. 
The  bladder  cannot  be  completely  emptied  except  by  powerful 
contractions  of  the  abdominal  muscles.  Habitually  it  may  es- 
cape in  drops,  or  in  jets  at  intervals  during  exercise.  Palpation 
will  show  overdistended  bladder  as  a  tense,  elastic  mass.  But  as 
overdistension  may  occur  without  paralysis,  no  case  can  be  cer- 
tainly diagnosed  without  catheterization  to  show  that  the  urethra 
is  free. 

When  the  paralysis  affects  the  cervix,  the  urine  escapes  con- 
tinually and  trickles  down  the  insides  of  the  hips  in  mares,  or 
from  the  sheath  in  males. 

Diagnosis  demands  catheterism  and  rectal  examination. 

Complication.     Cystitis  by  retention.     Infection  by  catheter. 

Treatment,  Corresponds  to  causes.  These  corrected,  use 
aseptic  catheter  often.  After  extreme  distension  empty  partially, 
or  inject  a  few  ounces  of  borax  or  boric  acid  solution.  Thus 
avoid  collapse  and  inflammation,  and  secure  antisepsis.  Give 
tone  by  a  course  of  strychnia,  (ergot,  belladonna),  mustard 
blister  ;  turpentine  in  small  doses.  Better  electricity,  i  pole  in 
bladder,  i  on  public  symphysis.     Apply  for  5  minutes. 


TUMORS  OF  THE  BLADDER. 

Recorded  cases  of  sarcoma  (Mauri),  carcinoma  (Cadeac, 
Hink,  Friedberger),  and  tuberculosis  can  be  adduced.  Papilloma 
is  perhaps  as  frequent  as  any  of  the  above.  The  author  has 
treated  two  cases  of  papilloma  in  mares  complicated  with  multiple 
small  calculi  and  gravel.  Treatment  is  exclusively  surgical  and 
in  the  mare  with  the  widely  dilatable  urethra  this  is  sometimes 
possible  through  that  channel.  In  the  same  animals  diagnosis 
may  be  accomplished  by  introducing  the  finger  into  the  urethra 
and  bladder.  In  other  females  and  males,  vaginal  or  rectal  pal- 
pation must  be  resorted  to. 


VESICAL  PARASITES. 

Eustrongylus  gigas.     Dog,  horse,  man. 
Trichosoma  plicata.     Dog. 
(Estrus  Haemorrhoidalis.     Mare. 


SPASM  OF  NECK  OF  BLADDER. 

Spasm  of  the  cervix  vesicae  has  been  doubted,  save  as  the  re- 
sult of  local  inflammation,  yet  it  not  uncommonly  takes  place  in 
horses  and  other  animals  in  connection  with  irritation  attendant 
on  the  retention  of  urine  during  work,  or  in  dogs  during  a  period 
passed  indoors.  Trouble  and  sufiFering  continues,  with  ineffectual 
efforts  to  micturate,  but  practically  complete  relief  is  secured  by 
catheterization  or  by  a  spontaneous  abundant  discharge.  The 
neurosis  which  leads  to  it  is  produced  or  aggravated  at  times  by 
enlarged  prostate,  or  lesions  in  the  urethra.  Intense  fear  may 
cause  it. 

Treatment,  Remove  cause.  Give  antispasmodics,  valerian, 
musk,  bromides,  chloral  hydrate,  opium,  stramonium,  hyoscya- 
mus,  codeine,  etc. ;  may  be  given  as  injections  or  suppositories. 
For  the  horse  spread  the  litter  and  soothe  by  whistle  or  song.  Or 
use  the  catheter  and  correct  any  local  irritation. 
261 


RUPTURE  AND  LACERATION  OF  THE  BLADDER. 

This  occurs  most  commonly  in  oxen  from  obstruction  of  the 
urethra  by  a  calculus.  Similar  obstruction  in  the  horse  causes 
most  acute  symptoms,  calling  for  immediate  relief,  and  rupture  is  a 
comparatively  rare  occurrence.  Peuch  mentions  a  case  resulting 
from  a  fall  during  an  attack  of  colic,  and  with  a  full  bladder.  It 
has  happened  during  lithotrity,  or  lithotomy,  and  even  during 
parturition.  Perforation  by  parasites  has  been  noted  and  in  one 
case  by  an  osseous  tumor  of  the  pubic  symphysis.  In  horses  a 
fatal  result  is  prompt,  in  cattle  from  6  to  48  days. 

Treatment  surgical. 


EVERSION  OF  THE  BLADDER. 

This  is  really  invagination  into  the  female  urethra  and  vagina. 
It  has  only  been  seen  in  mares,  and  then  by  reason  of  the  ex- 
treme dilatability  of  the  urethra.  A  pyriform,  red,  perhaps  ru- 
gose tumor  shows  between  the  lips  of  the  vulva,  during  strain- 
ing. It  is  covered  by  mucosa,  and  on  its  upper  surface  near  to 
its  neck  are  two  small  orifices  from  which  urine  oozes  or  comes 
in  jets  during  active  expulsive  efforts.  It  soon  becomes  muco- 
purulent on  the  surface,  and  even  excoriated.  Urine  escaping 
continuously  trickles  down  the  thighs  with  much  foetor.  It 
occurs  especially  during  violent  expulsive  eflForts  as  in  parturition 
or  constipation. 

Treatment  essentially  surgical  consists  in  uniform  compression 
to  expel  blood  and  exudate  followed  by  the  pushing  of  the 
fundus  through  the  bladder  and  urethra.  The  more  recent  the 
case,  the  easier  is  the  process.  Pressecq  claims  to  have  cured  an 
obstinately  recurring  case,  by  cauterizing  the  urethra  up  to  the 
cervix  vesicae  with  a  round  iron  rod  an  inch  in  diameter.  The 
resulting  loss  of  substance,  with  the  neoplasia  and  constriction 
effectually  prevented  renewed  eversion  even  during  parturition. 
Other  veterinarians  have  successfully  excised  the  bladder,  but 
this  entailed  incontinence  and  constant  offensive  soaking  of  the 
thighs  with  urine. 
262 


HERNIA  OF  THE  BLADDER. 

This  is  commonly  seen  in  the  mammalian  female  in  connection 
with  rupture  of  the  floor  of  the  vagina  during  dystokia.  It  has 
also  been  observed  without  such  lesion  in  both  male  and  female 
dogs  and  horses,  the  bladder  forming  a  cystocele  of  the  vagina, 
or  bulging  between  the  anus  and  the  ischium. 

Diagnosis  is  confirmed  by  careful  palpation  through  the 
rectum.  The  folding  of  the  bladder  backward  obstructs  the  exit 
of  urine. 

Treatment,  essentially  surgical,  might  include  replacing  of  the 
organ  and  suturing  of  the  wound,  or,  in  the  absence  of  a  wound, 
evacuation  of  the  bladder  by  a  hypodermic  needle,  and  replacing 
by  palpation  through  the  vagina  or  rectum.  Sometimes  suture 
of  the  vulva  is  desirable. 


ANOMALIES  OF  THE  BLADDER. 

Persistent  urachus.  Seen  in  the  new-bom  and  mainly  in 
males.  Antiseptic  closure  is  essential  after  having  ascertained 
that  the  urethra  is  pervious. 

Imperforate  cervix  vesicae.  A  case  reported  by  Lapotre,  in 
a  calf,  had  no  cervical  orifice,  and  the  ureters  were  blocked 
by  pea-shaped  nodules. 

Recto- vesical  fistula.  In  a  calf  13  days  old  the*  rectum 
opened  into  the  bladder  and  the  faeces  and  urine  escaped  by  a 
pervious  urachus.     (Kaufmann  and  Blanc). 


URETHRAL  ANOMALIES. 

Imperf orations.     In  the  new  born  male,  foal,  lamb,  etc.  Usually 

at  the  outer  end,  and  it  may  be  for  some  distance  back.     In  one 

case  the  sheath  was  firmly  adherent  on  the  wall  of  the  abdomen, 

thus  shutting  off  all  exit  of  urine.     If  the  canal  is  absent  only  at 

263 


264  Veterinary  Medicine. 

the  orifice  or  for  a  short  distance,  the  urethra  beyond  this  can  be 
felt  full  of  liquid  and  fluctuating.  The  patient  being  properly 
fixed  a  fine  trochar  is  pushed  from  the  end  of  the  penis  into  the 
blind  end  of  the  urethra,  which  will  be  ascertained  by  the  over- 
coming of  resistance.  The  trochar  is  now  withdrawn  aud  the 
urine  flows  through  the  cannula.  A  catheter  or  sound  is  now  tied 
in  the  passage  to  maintain  it  pervious  until  cicatrization  shall 
have  taken  place. 

Hypospadias.  Short  urethra  opening  backward  on  the  lower 
surface  of  the  penis.     Considered  irremediable. 

Epispadias.  Urethra  opening  on  the  upper  surface  of  the  penis. 
Much  more  rare. 


ACUTE  URETHRITIS.  CATARRH  OF  THE  URETHRA. 

This  occurs  in  all  genera  of  domestic  animals,  and  may  be 
either  acute  or  chronic.  It  is  most  common  in  the  entire  males, 
not  only  because  of  infections  sustained  in  copulation,  but  be- 
cause frequent  erection  exposes  the  opening  of  the  urethra  to  in- 
jury and  inflammation,  and  to  the  entrance  of  pathogenic  germs. 

Symptoms.  Pruritus  of  the  penis,  and  diflSculty  and  pain  in 
urination  and  straining  are  frequent,  but  a  single  small  jet  may  be 
all  that  is  passed  at  a  time.  The  papilla  on  the  end  of  the 
penis  is  red  and  angry  and  somewhat  swollen.  Later  a  few 
drops  of  muco-purulent  fluid  may  be  pressed  from  the  orifice. 
In  the  bull,  dog  and  boar  this  oozes  from  the  retracted  penis  into 
the  sheath,  so  that  a  collection  is  found  in  that  canal,  and  the 
mucosa  becomes  infected  causing  a  balanitis. 

The  infection  may  be  conveyed  from  male  to  female  and  vice 
versa.  Dr.  Horand  of  Lyons  even  found  that  the  muco-purulent 
discharge  of  gonorrhoea  in  man  caused  an  urethral  catarrh  in  the 
dog,  which  however  did  not  persist  for  any  great  length  of  time. 

Diagnosis  is  based  on  frequent  and  painful  urination  in  jets, 
tenderness  of  the  urethra  under  palpation  or  catheterization,  red- 
ness and  swelling  round  the  urethral  orifice,  and  the  oozing  of 
pus.  In  the  absence  of  any  external  injury  one  should  always 
ascertain  if  cystitis  is  present. 

Prognosis  is  favorable  under  appropriate  treatment.  Spon- 
taneous recovery  will  usually  occur  early. 


Wounds  of  the  Urethra,  265 

Treatment,  Dilute  the  urine.  Give  pure  water  to  drink  at 
will,  or  flaxseed  gruel,  or  gum  or  barley  water.  Alkaline  car- 
bonates. In  the  early  stage  foment  and  use  injection  of  potassium 
permanganate  (2  grs.  to  i  oz.).  Later  may  be  used  more 
astringent  agents  (boric  acid  i  :  100,  zinc  sulphate  i  :  100,  lead 
acetate  i  :  100,  p6tass  chlorate  3  :  100.  In  the  presence  of  great 
pain  cocaine  muriate  2  :  100).  There  is  danger  of  stricture  from 
the  stronger  astringents  or  caustics  in  the  early  stages  before  sup- 
puration. To  complete  the  cure  give  copiaba,  buchu,  resin,  or 
essence  of  turpentine. 


WOUNDS  OF  THE  URETHRA. 

Acual  wounds  occur  in  surgical  operations,  or  accidentally  as 
by  shafts,  poles,  forks,  hooks,  bites,  etc.,  or  from  calculus  or  a 
catheter  forced  into  a  false  route.  An  arrested  or  slowly  moving 
calculus  has  been  known  to  induce  several  perforating  ulcers 
causing  infiltration  of  urine  and  infecting  germs  into  the  connec- 
tive tissue.  This  determines  rapidly  increasing  oedematous  fluctu- 
ating tumors.  Gangrene  and  septic  intoxication  are  common  re- 
sults, especially  in  cattle. 

•Longitudinal  wounds  keep  more  open  and  heal  more  readily 
than  transverse  wounds,  probably  because  the  circular  muscular 
fibres  in  contracting,  pull  the  edges  apart  and  counteract  stricture, 
the  breach  being  filled  up  by  granulations.-  The  perineal  wound 
in  lithotomy  will  heal  thus  in  20  days,  while  that  made  in  ampu- 
tation of  the  penis  is  exceedingly  liable  to  circular  contraction 
and  stricture  or  occlusion. 

Contusions  of  the  perineum,  may  cause  lacerations  of  the  urethra 
and  haemorrhages,  with  bloody  discharge  or  sanguineous  swelling. 

Treatment.  Will  vary.  Calculi  must  be  diagnosed  and  removed. 
Breach  of  the  walls  of  the  urethra  may  necessitate  frequent 
catheterization  or,  better,  the  wearing  of  a  catheter.  Escape  of 
urine  into  the  connective  tissue  should  be  met  by  a  counter  open- 
ing in  the  skin  to  drain  the  part  and  allow  free  antisepsis.  Simi- 
lar resorts  are  required  for  urinary  infiltration,  accompanied  by 
antiseptic  injection  subcutem.  Abscesses  must  be  located,  punc- 
tured with  trochar  and  cannula,  evacuated  and  injected  anti- 
septically. 


FOREIGN  BODIES  IN  THE  URETHRA. 

Apart  from  calculi,  may  be  found  straws,  glumes,  chaff  and 
catheters  and  even  stones  and  small  bodies  which  must  have  been 
introduced  deliberately.  An  irritation  corresponding  to  the  offend- 
ing mass  and  its  seat,  ensues,  and  must  be  treated  by  soothing 
and  anti-phlogistic  measures  while  the  offending  body  must  be 
found  and  completely  extracted. 


STRICTURE  OF  THE  URETHRA. 

This  may  be  suspected  when  in  spite  of  much  straining  the 
urine  is  habitually  passed  in  a  very  fine  stream,  which  has  be- 
come finer  and  finer  for  a  length  of  time,  without  complete  arrest 
as  in  calculus.  The  introduction  of  a  catheter  will  confirm  the 
diagnosis  and  show  the  exact  seat  of  the  stricture. 

It  is  determined  by  irritation  caused  by  calculus,  urethritis, 
ulcer,  wounds,  etc. ,  which  tend  to  the  formation  of  a  cicatrix  en- 
circling and  narrowing  the  canal.  One  efficient  cause  is  the  in- 
jection of  strong  astringent  or  slight  caustic  solutions  in  the  early 
stages  of  urethritis. 

Treatment  is  by  dilation,  by  bougies  pointed  and  gradually 
thickening,  or  simply  by  an  elastic  staff  which  at  first  passes  with 
some  force  and  is  replaced  by  a  larger  one  as  the  urethra  stretches 
under  daily  use. 

Catheterization.  In  connection  with  diseases  of  the  bladder 
and  urethra  the  passing  of  the  catheter  is  a  most  important  opera- 
tion which  requires  considerable  skill  on  the  part  of  the  operator. 
A  short  statement  of  the  method  to  be  adopted  for  each  of  the 
domestic  animals  will  therefore  be  in  place. 

Catheterization  in  the  male  Soliped.  The  catheter,  a  hollow,, 
gum  elastic  tube,  must  be  proportioned  to  the  size  of  the  animal, 
but  for  the  average  adult  horse  about  3j4  feet  in  length  and  ys 
inch  in  thickness.  To  give  it  the  requisite  solidity  and  resist- 
ance it  is  usually  furnished  with  a  stilet  of  whalebone  or  cane. 

The  operation  is  performed  with  the  animal  standing,  in  quiet 
266 


Stricture  of  the  Urethra,  267 

animals  without  any  restraint,  but  in  the  more  sensitive  or 
restive,  with  one  fore  foot  held  up ;  or  with  both  hind  feet  in 
hobbles  furnished  with  ropes  passing  between  the  fore  limbs  and 
tied  over  the  neck  in  front  of  the  withers  ;  or  finally  with  a 
twitch  on  the  nose. 

The  rectum  is  emptied,  and  with  the  oiled  or  soapy  hand  the 
penis  is  found  and  slowly  withdrawn  from  the  sheath  by  steady 
traction.  This  is  usually  easy,  though  in  certain  cases,  with  a 
short  penis  and  specially  strong  retractors,  it  will  seriously  tax 
the  operator's  skill  and  address.  In  a  specially  obstinate  case  a 
hypodermic  injection  of  morphine  may  be  resorted  to. 

If  the  horse  is  down,  as  in  paraplegia  or  haemoglobinaemia,  he 
may  lie  on  his  right  side  while  the  operator  stoops  over  him  from 
the  loins  ;  or  his  feet  may  be  drawn  together  by  hobbles,  and  the 
subject  turned  on  his  back,  the  operator  placing  himself  as  before 
on  the  left  side. 

The  catheter  must  have  been  previously  cleansed  and  disin- 
fected outside  and  in.  A  mercuric  chloride  solution  i  :20oo,  or 
boric  acid  i  :  50  or  permanganate  of  potash  i  :  50  may  be  em- 
ployed. Then  it  must  be  smeared,  preferably  with  vaseline 
but,  in  case  of  necessity,  with  sweet  oil,  glycerine,  borated  lard, 
of  even  castile  soap. 

The  penis  being  withdrawn  from  the  sheath,  the  catheter  con- 
taining its  stilet  is  introduced  into  the  urethra  and  pushed  on 
slowly  and  carefully  until  its  point  can  be  felt  over  the  ischiatic 
arch.  The  stilet  is  now  drawn  out  a  few  inches  and  the  point  of 
the  catheter  is  bent  forward  over  the  ischium  by  the  finger.  The 
stilet  is  further  drawn  out  and  the  catheter  can  easily  be 
pressed  on  into  the  bladder.  If  any  difficulty  is  experienced  it 
may  be  guided  by  the  hand  introduced  into  the  rectum. 

In  a  number  of  cases,  I  found  that  the  catheter  entered  a 
dilated  seminal  vesicle  and  failed  to  evacuate  the  bladder.  This 
untoward  occurrence  must  be  rectified  by  the  aid  of  the  hand  in 
the  rectum.  Usually  the  penetration  of  the  bladder  is  signalized 
by  the  overcoming  of  resistance,  and  when  the  stilet  is  withdrawn 
the  urine  flows  in  a  steady  stream.  If  it  fails  to  flow,  a  slight 
compression  of  the  fundus  of  the  bladder  by  the  hand  engaged  in 
the  rectum  will  start  the  stream. 

The  catheter  should  be  withdrawn  slowly  and  carefully. 


268  Veterinary  Medicine. 

Catheterization  in  the  Bovine  Male.  Most  veterinarians 
suppose  that  this  is  impossible,  owing  to  the  narrowness  of  the 
sheath  interfering  with  the  extraction  of  the  penis,  and  the  S 
shaped  curve  in  the  penis  preventing  the  introduction  of  the 
catheter.  Both  obstacles  can,  however,  be  overcome  in  many 
cases.  The  bull  may  be  tempted  to  protrude  the  penis  by  the 
presentation  of  a  cow  in  heat,  or  in  bull  or  ox  the  bulging 
anterior  part  of  the  organ  may  be  protruded  by  careful  manipula- 
tion through  the  sheath.  Then  the  free  extension  of  the  penis 
can  be  made  to  eflFace  the  S  shaped  curve.  The  catheter  must  be 
small,  not  much  over  a  line  in  caliber,  and  a  metal  stilet  is  em- 
ployed. The  animal  may  have  to  be  placed  under  restraint,  and 
the  same  antiseptic  precautions  are  demanded  as  in  the  horse. 

Catheterization  in  the  Ram  and  Wether.  These  must  be 
dealt  with  like  the  bull,  the  only  additional  diflSculty  being  in  the 
vermiform  appendix.  This  is  small  and  sinuous  but  the  longitudi- 
nal opening  on  its  lower  surface  is  favorable  to  the  introduction 
of  the  catheter. 

Catheterization  in  the  Dog.  The  fact  that  the  urethra 
traverses  the  groove  on  the  lower  aspect  of  the  bone  of  the  penis, 
is  held  to  prove  an  obstacle  to  the  catheter,  yet  the  introduction 
of  the  later  is  in  no  sense  difficult.  Small  or  moderately  sized 
dogs,  may  be  held  upright,  the  body  resting  on  the  rump  and  the 
pelvis  inclined  forward,  which  will  favor  the  spontaneous  pro- 
trusion of  the  penis.  Or  it  may  be  pressed  out  by  manipulation 
through  the  sheath.  The  catheter  ^  ds.  to  i  line  in  diameter 
may  be  i^  to  2  feet  in  length  according  to  the  size  of  the  animal. 
It  should  be  used  aseptic. 

Catheterization  of  the  Mare.  Nothing  can  be  easier  than 
this  operation  in  the  mare.  The  shortness  and  dilatability  of  the 
urethra,  and  the  accessibility  of  its  external  orifice  in  the  center 
of  the  floor  of  the  vulva,  4  or  5  inches  in  front  of  the  lower  commis- 
sure, favors  the  introduction  of  the  catheter.  The  latter  may  be  a 
foot  in  length,  perfectly  straight  and  it  may  be  constructed  of  silver 
or  some  other  metal,  which  may  be  readily  boiled  and  rendered 
aseptic.  In  the  absence  of  a  catheter  the  germ  free  nozzle  of  a  rectal 
syringe  may  be  used,  or  two  fingers  may  be  passed  through  the 
urethra  and  parted  from  each  other  so  as  to  allow  the  exit  of  the 
urine. 


Acute  Prostatitis  and  Hyperemia  of  the  Prostate,  269 

Catheterization  of  the  Cow  and  Heifer.  The  operation  is 
often  very  difficult  in  the  cow,  by  reason  of  the  small  size  and  un- 
dilatability  of  the  urethra,  and  by  the  presence  of  two  blind  ducts 
(canals  of  Goertner)  above  and  to  the  two  sides  of  the  urethral 
opening.  The  thin  rigid  upper  margin  of  the  orifice  projects 
down  over  it  in  a  valvular  manner  so  that  the  catheter  will  almost 
always  find  its  way  into  one  of  the  blind  sacs.  By  introducing 
the  tip  of  the  index  finger  beneath  the  valvular  fold  and  into  the 
opening  of  the  canal,  the  catheter  may  be  directed  beneath  it  and 
into  the  bladder.  An  apparatus  consisting  of  a  series  of  ribs  of 
spring  wire  arranged  in  the  form  of  a  funnel  and  converging  at 
one  end  to  a  point  has  been  devised  to  insert  into  the  urethral 
orifice,  and  guide  the  catheter  which  is  passed  through  it.  A 
metallic  catheter  cut  off  obliquely  at  its  point  will  enter  easily. 

Catheterization  of  the  Bitch.  The  operation  is  rendered 
difficult  by  the  narrowness  of  the  passage,  and  the  puckers  and 
folds  of  the  vaginal  mucosa  which  serve  to  hide  the  urethral  ori- 
fice. A  small  catheter  like  that  used  on  the  male  is  used  or  a 
short  metallic  catheter  may  be  substituted.  By  directing  this 
forward  exactly  in  the  median  line  of  the  floor  of  the  vulva, 
with  gentle  pressure  downward  it  may  be  made  to  enter  the 
urethra.  In  case  of  special  difficulty  a  bivalve  speculum  may  be 
resorted  to,  to  efface  the  mucous  folds  and  reveal  the  orifice. 


ACUTE    PROSTATITIS    AND   HYPEREMIA    OF    THE 

PROSTATE. 

Causes  :  In  dogs,  house  life,  overfeeding,  compulsory  retention  of  urine, 
and  faeces,  constipation,  proctitis  (rectitis),  piles,  calculi,  strangury,  uric 
acid,  urethral  ulceration  or  stricture,  rude  catheterization,  chill,  generative 
excitement  to  excess,  secondary  abscess  or  infection.  Forms.  Lesions  :  fol- 
licular, interstitial,  circumscribed  and  diffuse  suppuration.  Symptoms : 
frequent  straining  urination,  rectal  palpation,  incontinence  of  urine,  cos- 
tiveness,  tender  perineum,  dullness,  recumbency,  fever,  pus  in  urine,  col- 
lapse of  swelling,  fistula.  Diagnosis.  Prognosis  :  grave.  T?  eatment :  lax- 
atives, mercurials,  salines,  leeches,  acid  laxative,  non-ttimulating,  camphor, 
bromides,  ergot,  witch  hazel,  opium,  belladonna,  enemata  of  cold  water,  or 
ice  suppository,  catheterization,  perineal  incision,  anti-septics. 

Causes.     This  is  most  commonly  seen  in  dogs,  in  which  it  may 


270  Veterinary  Medicine, 

depend  on  house  life  with  overfeeding  on  stimulating,  spiced, 
albuminous  food,  compulsory  restraint  of  urination  and  defeca- 
tion in  obedience  to  the  demands  of  cleanliness,  distended  bladder, 
and  rectum,  constipation,  proctitis,  piles,  and  other  sources  of 
local  irritation.  In  all  animals  its  origin  is  favored  by  the  forma- 
tion or  arrest  of  calculi  in  the  prostate,  the  pelvic  urethra  or 
even  the  bladder  ;  by  drug  strangury  from  cantharides  or  other 
irritant  diuretic  ;  by  excess  of  urea,  uric  acid  or  other  irritant  in 
the  urine  ;  by  infection  extending  from  the  urethra  or  bladder  ; 
by  ulceration  or  stricture  of  the  urethra  ;  by  rude  or  incautious 
catheterization,  or  injection  ;  by  exposure  to  cold  ;  and  by  local 
infection  in  pyaemia  and  other  general  zymotic  disorders.  Most 
of  these  conditions  conduce  to  local  excitement  and  hyperaemia, 
which  from  adjacent  organs,  are  sympathetically  transferred  to 
the  prostate.  The  same  is  true  of  frequent,  and  intense  genera- 
tive excitement  which  according  to  Lafosse  and  Cadiot  is  a  com- 
mon cause  of  prostatitis  in  stud  horses.  Again  the  abscess  of 
strangles,  may  become  localized  in  the  prostate,  or  the  nodule  of 
glanders,  or  the  tubercle  of  tuberculosis  (cattle,  pigs,  dogs). 
Cadiot  suggests  that  in  animals,  divested  of  the  tail,  external 
injuries  to  the  perineum  may  extend  by  continuity  to  the  prostate, 
as  happens  to  man  from  horseback  or  bicycle  riding.  He  adduces 
no  cases  however.  The  habit  of  masturbation  acquired  by  cer- 
tain males  may  also  be  adduced  theoretically  as  both  cause  and 
consequence  of  prostatitis  but  future  observation  must  show  how 
frequently  this  really  operates. 

Forms.  Lesions.  According  to  the  nature  of  the  lesions  the 
affection  has  been  divided  into  different  forms  :  ist.  Follicular  or 
Parenchymatous ;  2d,  Diffuse  or  Interstitial ;  3d,  Circum- 
scribed Prostatic  Abscess ;  4th,  Multiple  Miliary  Abscesses. 

Follicular  Prostatitis  implicates  primarily  the  follicles  and 
gland  ducts  and  finally  the  entire  gland  tissue.  It  is  usually 
associated  with  and  doubtless  often  proves  an  extension  from  an 
adjacent  infective  urethritis,  and  tends,  in  persistent  cases,  to  go 
on  to  interstitial  inflammation  and  abscess,  or  hypertrophy.  This 
is  characterized  by  more  or  less  swelling  of  the  prostate,  with 
increased  vascularity  of  its  mucosa  and  the  oozing  from  its  open- 
ings and  gland  ducts  under  pressure,  of  a  thick,  yellow,  gelatinoid 
fluid  containing  pus  and  granular  epithelial  cells  and  sometimes 
striae  of  blood. 


Acute  Prostatitis  and  Hypentmia  of  the  Prostate.  271 

Diffuse  (Interstitial)  Prostatitis  shows,  in  addition  to  the 
general  swelling  and  muco-purulent  discharge,  a  considerable 
exudate  into  the  interstitial  tissue,  with  increased  tension  and 
resistance  of  its  substance.  It  is  associated  during  life  with  more 
fever  and  constitutional  disturbance  than  th^  simple  catarrhal  or 
follicular  form. 

In  Circumscribed  Prostatic  Abscess  we  find,  in  addition  to 
the  general  hyperaemia  and  swelling,  a  much  more  prominent 
local  swelling,  the  seat  of  intense  inflammation,  at  first  firm  and 
resistant  and  later  softer  and  fluctuating  in  the  center,  which  is 
filled  with  pus.  This  may  have  its  origin  in  the  follicular  form, 
the  pus  becoming  shut  up  in  a  follicle  and  gradually  increasing 
until  it  bursts  into  the  urethra,  the  bladder,  the  rectum,  the  peri- 
toneum, or  pelvic  fascia  and  perineum.  In  other  cases  it  becomes 
complicated  by  pyaemia  and  secondary  abscesses. 

Miliary  Abscesses  may  be  comparatively  few  in  number  or 
generally  diffused  through  the  prostate,  and  are  often  the  result 
of  a  pre-existing  general  infection. 

Symptoms.  As  the  disease  usually  begins  as  a  local  infection 
the  first  symptoms  are,  as  a  rule,  unattended  by  fever,  which, 
however,  appears  in  two  or  three  days  as  the  local  lesions  in- 
crease. The  urine  may  be  passed  frequently  in  small  amounts, 
or  there  may  be  frequent  straining  without  passage  of  urine,  the 
pressure  of  the  swollen  prostate,  with  or  without  spasms  of  the 
sphincter  vescicse,  causing  retention.  It  is  no  uncommon  thing 
to  find  the  last  urine  passed  of  a  milky  or  glairy  character  and, 
coagula  moulded  in  the  prostatic  canals  may  at  times  be  found. 
The  presence  of  spermatic  crystals,  fusiform,  with  very  pointed 
extremities,  and  precipitated  on  the  addition  of  ammonium  phos- 
phate, is  characteristic  of  prostatic  fluid.  (Fiirbringer).  In 
other  cases  there  is  incontinence,  the  urine^  dribbling  away  in- 
voluntarily as  the  animal  walks,  and  especially  if  anything  occurs 
to  excite  him.  Micturition  may  be  painless  or  attended  by  acute 
suffering,  which  causes  a  sudden  arrest  of  the  flow.  Defecation 
is  attended  with  difficulty  and  more  or  less  pain,  and  obstinate 
constipation  is  likely  to  set  in.  The  animal  is  dull,  spiritless  and 
seeks  to  lie  undisturbed.  Pressure  on  the  perineum  is  painful 
and  exercise  aggravates  the  symptoms.  Rectal  examination  by 
the  hand  or  finger  according  to  the  size  of  the  animal,  reveals 


272  Veterinary  Medicine, 

the  enlarged,  tender  prostate  lying  on  the  cervix  vesicae.  This 
swelling  may  be  unilateral  but  most  commonly  it  is  bilateral  or 
general.  When  fever  sets  in  with  a  temperature  of  io2°-io4°, 
thirst,  anorexia  and  weakness  or  stiffness  in  the  hind  parts  may 
be  noticed.  In  case  of  abscess,  the  urine  may  be  perfectly  clear 
until  it  bursts  into  the  urethra  or  bladder  when  there  is  an 
abundant  flow  of  pus,  and  rectal  examination  shows  that  the 
swelling  and  tension  have  notably  diminished.  Should  it  burst 
into  the  rectum,  the  pus  shows  in  the  faeces.  Reinemann  records 
a  case  in  a  bull  with  dysuria,  oedema  of  the  sheath  and  a  swel- 
ling like  the  fist  in  the  perineum,  containing  pus,  and  which 
communicated  with  the  prostate  and  urethra.  With  the  rupture 
of  the  abscess  there  is  a  marked  amelioration  of  the  symptoms. 

Not  infrequently  the  affection  subsides  into  the  chronic  form 
and  the  abscess,  having  a  restricted  channel  for  evacuation,  re- 
mains as  a  suppurating  cavity. 

Diagnosis.  The  enlargement  and  tenderness  of  the  prostate 
as  felt  on  rectal  examination  is  pathognomonic.  If  the  body  of 
the  urine  is  clear  there  is  further  corroboration,  as  in  C3'stitis  it 
is  more  or  less  turbid  and  flocculent  or  even  bloodstained.  Mic- 
turition is  likely  to  be  much  more  frequent  in  cystitis  than  in 
prostatitis.  Catheterization  is  much  more  painful  when  the 
catheter  passes  the  prostate  in  prostatitis  than  in  cystitis. 

Prognosis  is  always  grave.  Some  cases  recover  completely, 
while  others  run  on  to  a  fatal  termination,  and  still  others  merge 
into  the  chronic  form.  Cases  that  are  complicated  by  abscess  are 
always  to  be  dreaded,  as  chronic  suppuration,  or  pelvic  or  perito- 
neal infection,  or  pyaemia,  or  septic  poisoning  is  liable  to  super- 
vene. As  the  disease  is  more  common  in  the  old  so  it  is  liable  to 
prove  more  severe  and  redoubtable. 

Treatment,  In  acute  cases  active  derivation  toward  the  bowels 
is  desirable.  A  mercurial  purge  (calomel — horse  or  bull  i  to  2  drs ; 
dog,  2  to  5  grs. )  may  be  followed  a  few  hours  later  by  salines 
(sodium  sulphate — horse  or  bull  i  lb.  ;  dog  i  oz.).  Sodium  sul- 
phate or  magnesium  sulphate  may  also  be  given  with  glycerine  as 
an  enema.  Great  benefit  may  often  be  obtained  from  the  applica- 
tion of  leeches  on  the  perineum  or  around  the  anus.  The  diet 
must  be  restricted  and  non-stimulating,  mainly  of  amylaceous 
materials,  and  with  the  water,  flaxseed  tea  may  be  liberally 


Chronic  ProstaHHs,  273 

mixed.  When  the  suffering  is  severe  it  may  be  met  by  camphor, 
camphor  bromide,  ergot,  hamamelis,  gelsemium  or  potassium 
bromide,  given  by  the  mouth  or  rectum.  With  violent  strangury, 
opium,  belladonna  or  hyoscyamus  may  be  tised.  Some  cases  may 
be  relieved  by  the  use  of  enemata  of  cold  water,  or  pieces  of  ice 
in  the  rectum.  In  retention  of  urine,  careful  catheterization  is 
imperative,  the  hand  or  finger  in  the  rectum  being  employed  to 
guide  the  point  of  the  catheter  under  the  prostate. 

In  case  of  abscess  an  opening  by  the  side  of  the  anus  is  prefer- 
able to  one  by  the  urinary  passages  or  rectum,  and  will  obviate  the 
danger  of  rupture  into  the  peritoneum.  A  pasty  or  fluctuating 
swelling  in  the  perineum  should  be  incised  until  the  pus  flows. 
A  tense  elastic  fluctuating  prostate  may  be  transfixed  by  a  can- 
nula and  trochar  from  the  side  of  the  anus,  guided  by  the  hand 
or  finger  in  the  rectum.  When  the  pus  has  been  evacuated 
a  drainage  tube  may  be  inserted  through  the  cannula  and 
left  in  place  when  the  latter  is  removed  so  as  to  allow 
free  drainage  at  all  times  and  frequent  antiseptic  injections. 
Punctures  and  even  incisions  have  been  made  from  the  rectum, 
but  they  make  badly  infected  wounds,  and  a  rupture  into  the 
urethra,  determines  infection  on  that  side,  without  any  possibility 
of  any  effective  antiseptic  injection  or  perfect  drainage.  As  in- 
jections may  be  used  permanganate  of  potash  i  :  loooo,  or  boric 
acid,  a  saturated  solution.  Poisonous  agents  must  be  eschewed 
or  used  with  the  greatest  circumspection. 


CHRONIC  PROSTATITIS. 

Causes.  Pollows  acute.  Same  caujtes  leas  potent.  Lesions  :  as  in  acute, 
or  sclerosis,  and  abscess.  Symptoms :  delayed  urination,  last  glairy  or 
purulent,  constipation,  defecation  followed  by  urethral  discharge,  little 
genital  ardor,  rectal  pa1pati>ii,  tenderness  of  prostate  to  hand  or  catheter, 
atony  of  hind  limbs.  Treatment :  open  air  life,  idle,  milk  or  succulent  diet, 
saline  laxatives  or  enemata,  avoid  generative  excitement,  castrate,  check 
masturbation,  iodine,  camphor,  antiseptic  irrigations. 

Causes,     The  acute  disease  often  subsides  leaving  an  indolent 
chronic  inflammation  of  the  organ.     Apart  from  this,  the  causes 
18 


274  Veterinary  Medicine, 

are  essentially  those  of  the  acute,  but  acting  with  lessened  force 
or  on  a  less  susceptible  system.  Thus  indoor  life  and  overfeeding, 
with  constipation  and  urine  of  a  high  density,  calculus,  irritant 
diuretics,  the  frequent  incautious  use  of  the  catheter,  infection 
from  the  catheter  or  otherwise,  intense  and  frequent  generative 
excitement,  and  exposure  to  cold  are  all  occasional  factors.  Old 
age  is  a  common  concurrent  cause. 

Lesions,  As  in  the  acute  form  these  indicate  three  successive, 
independent  or  concurrent  forms,  follicular,  interstitial  and  sup- 
purative. 

With  the  distinctly  follicular  form  the  gland  is  usually  en- 
larged and  of  a  deep  red  color,  but  soft  and  friable,  and  when 
compressed  exudes  from  its  follicles  and  gland  ducts  a  whitish 
muco-purulent  glairy  liquid.  With  the  interstitial  changes, 
which  are  often  an  advance  on  the  follicular,  the  organ  may  be 
enlarged  or  shrunken,  but  the  connective  tissue  has  undergone  a 
thickening  and  sclerosis  which  renders  the  mass  firm  and  re- 
sistant, and  which  may  have  extended  to  the  tissues  in  the  im- 
mediate vicinity.  '  In  the  suppurative  form  or  stage,  foci  of 
suppuration  are  found  throughout  the  gland  substance,  bulging 
out  on  its  surface  and  even  encroaching  on  surrounding  tissues. 

Symptoms.  These  are  by  no  means  obtrusive.  There  may  be 
some  delay  in  the  discharge  when  the  animal  attempts  to  urinate, 
and  the  last  drops  of  the  urine,  white  and  purulent  or  glairy,  may 
be  passed  with  evident  pain.  There  is  a  tendency  to  constipa- 
tion with  painful  straining  to  defecate.  Compression  of  the 
prostate  during  defecation  presses  out  its  muco-purulent  contents 
so  that  there  is  a  greater  urethral  discharge  following  this  act 
than  at  other  times.  This  is  also  more  abundant  from  the  com- 
pression of  the  abdomen  when  the  animal  is  lying  down.  This 
discharge  is  easily  distinguished  from  semen  by  the  absence  or 
almost  complete  absence  of  spermatozoa  and  the  abundance  of 
spermatic  crystals,  precipitated  by  ammonia  phosphate.  In  the 
earlier  stages  there  may  be  undue  generative  excitement,  erec- 
tions, and  even  seminal  discharge,  with  or  without  the  move- 
ments of  masturbation  but  in  advanced  cases  genital  ardor  is 
usually  defective  or  there  may  be  practical  impotence.  Con- 
clusive evidence  is  obtained  by  rectal  exploration,  when  the  en- 
larged, or  irregularly  shaped  and  tender  prostate  can  be  easily 


Chronic  Prostatitis,  275 

recognized.  If  a  sterile  catheter  is  passed,  the  pain  caused  as 
it  touches  the  prostate  is  significant. 

In  the  dog  the  afFection  may  last  for  years,  and  tends  to 
advancing  atony  of  the  hind  limbs.  A  temporary  arrest  of  the 
affection  is  often  misleading,  though  the  urine  may  be  clear  and 
normally  discharged,  yet  manipulation '  may  show  a  gradually 
advancing  abscess,  and  when  this  bursts,  usually  into  the  urethra, 
all  the  symptoms  become  aggravated  and  cystitis,  urethritis 
and  general  infection  are  to  be  dreaded. 

Treatment,  This  is  far  from  satisfactory  yet  in  certain  purely 
follicular  or  catarrhal  cases  it  may  prove  successful.  An  open 
air  life,  without  exertion,  and  a  milk  and  farina  diet  are  de- 
sirable, yet  any  tendency  to  costiveness  must  be  obviated  by 
saline  laxatives  and  enemata.  The  avoidance  of  generative  ex- 
citement must  be  secured,  not  only  by  restraining  stud  animals 
from  service,  but  by  keeping  them  well  apart  from  all  females 
of  the  same  species.  Even  castration  may  be  sometimes  re- 
sorted to  with  advantage.  Stallions  given  to  masturbation  must 
be  restrained  by  net  or  otherwise.  Any  disease  of  the  rectum, 
anus,  urethra  or  bladder  should  be  corrected,  and  undue  ex- 
posure to  cold  prevented.  Lafosse  advises  to  slaughter  butcher 
animals  for  food.  Hertwig  recommends  iodine  ointment  on  the 
anus  and  perineum  of  affected  dogs.  It  must  be  borne  in  mind 
that  the  affection  is  maintained  by  infective  microbes  yet  it  is 
diflScult  to  reach  and  deal  with  these  thoroughly  and  effectively. 

As  an  anaphrodisiac  may  be  given  camphor,  or  camphor  bro- 
mide, ergot  or  potassium  bromide,  along  with  the  mild  stimulating 
antiseptic  eucal3rptol,  piperazine  or  copaiba.  But  the  irrigation  of 
the  urethra,  bladder  and  as  far  as  pos.sible  the  prostate  with  such 
antiseptic  solutions  as  potassium  permanganate  (i  :  loooo)  or 
silver  nitrate  (0.5  to  i  :  100)  or  zinc  chloride  (i  :  100)  is  desir- 
able. These  should  be  injected  into  the  urethra  so  as  to  reach  the 
bladder,  the  contents  of  which  they  will  render  antiseptic  and  thus 
protect  the  organ  against  the  transported  microbes  of  the  prostate. 
In  man  iodoform,  europhen,  and  ichthyol  are  made  into  a  bougie 
with  gum,  palm  butter  or  other  soluble  liquefiable  agent  and  in- 
serted in  the  urethra  as  far  as  the  prostatic  part.  Similar  agents 
are  used  as  suppositories  or  enemata.  Hertwig' s  iodine  ointment 
on  the  perineum  may  be  advantageously  replaced  by  sinapisms. 


HYPERTROPHY  OF  THE  PROSTATE. 

In  old  dogs.  Causes  :  age,  overfeeding  on  albuminoids,  rectal  impaction 
or  irritation,  calculus,  cystitis,  urethritis,  productive  inflammation,  trophic 
derangement  when  function  declines.  Lesions  :  hypertrophy  general  or 
partial,  hard  or  soft,  condensed  or  with  sacs  of  pus,  red  or  pale  Infective 
cystitis.  Calculi.  Symptoms  :  straining  before  urine  comes,  small  or  weak 
stream,  sudden  check,  last  part  purulent  or  nmcous,  incontinence,  triple 
phosphate,  ammoniacal  odor,  crystals  and  dark  color  imply  calculus.  Diag- 
nosis :  by  rectal  exploration,  and  catheterization.  Treatment ;  palliative, 
moderate,  farinaceous,  laxative  diet,  warmth,  correct  contiguous  troubles 
Iodine,  castration,  extirpation  of  prostate. 

This  has  been  seen  almost  exclusively  in  old  dogs,  among  the 
domestic  animals. 

Causes.  Age  and  good  living,  more  particularly  on  highly 
albuminous  food,  may  be  adduced  as  the  most  prominent.  Per- 
haps even  more  important  are  continued  irritation  in  adjacent 
organs  such  as  the  rectum,  bladder  and  urethra.  It  is  the  old, 
pampered  dog  that  above  all  suffers  from  atonic,  overloaded 
rectum,  proctitis,  piles,  calculus,  cystitis,  and  stricture,  and  the 
constant  local  pelvic  congestion  caused  by  one  or  other  of  these 
tends  to  a  hyperplasia  of  the  prostate.  Again  atheroma  which  is 
especially  a  disease  of  the  aged  is  regarded  as  a  cause  of  both 
cystitis  and  prostatic  h5T)ertrophy.  Chronic  inflammation  in  the 
prostate  has  been  claimed  as  a  factor,  but  contested  on  the  ground 
that  inflammation  never  increases  normal  growth  though  it  may 
cause  degeneration.  The  exudate  of  inflammation,  tends,  how- 
ever, on  its  temporary  arrest,  to  undergo  organization,  and  such 
organization  inclines  to  assume  the  structure  which  is  normally 
built  up  by  the  adjacent  trophic  cells.  The  products  of  inflam- 
mation may,  therefore,  well  contribute  to  hypertrophy,  and  above 
all  to  the  increase  of  the  simpler  tissue  represented  by  the  fibrous 
framework  of  the  gland.  The  congestion  attendant  on  excessive 
venery  has  also  been  incriminated,  and  this  too  has  been  denied 
on  the  ground  that  the  h5T)ertrophy  is  not  found  in  the  young 
animals  and  men  in  which  the  generative  ardor  is  greatest  and 
most  frequently  aroused  and  gratified.  Thompson's  idea  is  that 
the  prostate,  like  the  ovaries  and  womb,  is  especially  prone  to 
276 


Hypertrophy  of  the  Prostate,  277 

morbid  growths  and  developments  at  the  time  when  in  advancing 
age,  the  normal  generative  functions  are  undergoing  a  rapid 
decline.  The  two  conditions  may  well  be  recognized  without  con- 
sidering them  as  mutually  excluding  each  other  as  causative 
factors. 

Lesions,  The  enlargement  is  usually  general,  but  it  may  pre- 
dominate in  the  right,  left  or  median  lobe,  the  latter  as  a  rule 
exercising  greater  compression  of  the  urethra  so  that  this  is  often 
marked  in  the  worst  cases.  The  hyperplasia  may  feel  firm  and 
resistant  or  it  may  be  more  or  less  soft  from  sacs  of  muco-puru- 
lent  fluid  imprisoned  by  the  obstruction  of  the  outlet  canals. 
On  the  surface  and  on  section  the  general  appearance  of  the 
gland  is  pale,  bloodless  and  uniformly  solid.  This  comes  from 
the  great  hypertrophy  of  the  fibro-muscular  stroma  which  has  in 
many  cases  compressed  the  parenchymatous  or  secreting  struc- 
ture so  as  to  cause  its  atrophy.  The  presence  of  calculi  (mainly 
phosphatic)  in  the  follicles  is  not  uncommon. 

The  complication  of  infective  cystitis  is  frequent,  the  congestion, 
redness,  ecchymosis,  maculation,  puckering  and  thickening  of 
the  mucosa,  the  granular  degeneration  and  desquamation  of  the 
epithelium,  the  exposure  of  a  raw  vascular  surface,  the  dis- 
coloration of  the  urine  by  mucus,  pus  and  blood,  and  the  forma- 
tion of  ammonia  and  other  products  of  decomposition,  becoming 
marked  phenomena.  Vesical  calculus  is  not  uncommon,  the 
slowness  of  the  exit  current  of  the  urine  retarded  by  the  en- 
larged prostate,  tending  to  prevent  its  impaction  in  the  orifice 
and  thus  minimizing  one  of  the  most  prominent  symptoms. 

Symptoms,  Among  the  earliest  symptoms,  is  some  modifica- 
tion in  the  act  of  micturition.  Straining  a  few  seconds  before 
urine  comes,  retention,  incontinence  and  dribbling,  discharge  in 
a  small  or  weak  stream,  and  sudden  arrest  of  the  flow  and  the 
last  few  drops  may  contain  muco-pus  showing  abundance  of  sper- 
matic crystals,  on  the  addition  of  ammonia  phosphate.  Impac- 
tion of  the  rectum  tends  to  occur  sooner  or  latter,  the  animal 
making  little  effort  to  unload  the  viscus,  and  the  overdistended 
organ  becoming  more  and  more  atonic,  congested  and  catarrhal 
and  reacting  injuriously  on  the  urinary  organs.  Incontinence 
may  be  especially  marked  during  sleep,  the  sphincter  being  suf- 
ficiently controlled  by  volition  during  waking  hours.     Retention 


278  Veterinary  Medicine, 

may  be  at  first  temporary  from  excitement  and  later  more  con- 
tinuous by  reason  of  the  greater  compression  of  the  neck  by  the 
enlarged  and  indurated  prostate.  With  the  advance  of  the  dis- 
ease the  urine  shows  abundance  of  triple  phosphates,  and  be- 
comes ammoniacal  and  foetid.  A  dark  or  bloody  color  of  the  dis- 
charge and  the  presence  of  crystals  suggest  calculus. 

An  accurate  diagnosis  can  only  be  had  by  rectal  examination. 
The  great  enlargement  of  the  prostate,  in  the  absence  of  heat 
and  tenderness  is  characteristic.  Enlargement  is  usually  uni- 
form, though  it  may  be  concentrated  on  the  right,  left  or  central 
lobe.  The  passage  of  the  catheter  may  be  obstructed,  but  is  not 
specially  painful  at  the  prostatic  region  as  in  prostatitis.  From 
vesical  calculus  it  is  distinguished  by  the  fixity  of  the  swelling 
on  the  neck  of  the  bladder  as  contrasted  with  the  mobility  of  the 
stone  inside  that  half- filled  organ.  From  stricture  it  is  differen- 
tiated by  the  fact  that  the  obstruction  offered  to  the  catheter  and 
the  swelling  of  the  prostate  exactly  correspond  in  position,  that 
the  stream  is  lessened  in  force  rather  than  simply  reduced  in  size, 
and  that  the  history  of  the  case  shows  no  antecedent  cause  for 
stricture. 

Treatment,  This  has  been  considered  as  mainly  palliative. 
Special  care  of  the  general  health  and  above  all  of  the  diet  which 
should  be  moderate,  farinaceous  and  laxative,  protection  against 
cold  and  wet,  the  correcting  of  any  coexisting  trouble  of  the 
urinary  or  generative  organs,  and  the  removal  from  all  sources  of 
generative  excitement  are  important  elements.  Occasional  small 
doses  of  Epsom  or  Glauber  salts  in  draught  or  enema  obviate 
rectal  hyperaemia.  Ergot,  potassium  iodide  internally,  and  iodine 
or  mercurial  ointment  to  the  perineum  have  had  little  good  effect. 
Moller  claims  to  have  secured  improvement  from  the  injection 
into  the  prostate  at  intervals  of  fourteen  days,  of  a  solution  of  two 
parts  each  of  tincture  of  iodine  and  iodide  of  potassium,  and  sixty 
parts  of  distilled  water.  A  small  hypodermic  syringe  is  used  and 
the  injection  is  made  through  the  rectum  directly  into  the  sub- 
stance of  the  prostate.  Glass  has  adopted  the  recent  surgical 
alternative  of  castration,  with  the  result  of  marked  relief  from  the 
active  symptoms  in  a  number  of  cases,  but  with  a  more  rapid 
advance  through  emaciation  and  marasmus  to  death  in  three  or 
four  weeks  in  others.     We  would  suggest  a  careful  antiseptic 


Tuberculosis  of  the  Prostate.  279 

castration  in  such  cases,  to  obviate  any  added  trouble  from  ab- 
sorbed toxins  or  sepsis. 

For  the  human  subject,  Lydston  strongly  advocates  removal  of 
the  enlarged  prostate  by  surgical  means  in  strong,  vigorous  sub- 
jects, with  healthy  bladder  and  kidneys.  The  difficulty  of  such 
an  operation  in  the  dog  is  greatly  enhanced  by  the  relatively 
greater  length  of  the  pubio-ischiatic  symphysis,  and  the  lessened 
diameter  of  the  pelvic  cavity.  Yet  with  the  comparative 
immunity  of  the  dog  from  suppuration,  and  the  hopelessness  of 
the  case  without  such  radical  measure,  and  with  the  rigid  applica- 
tion of  an  antiseptic  technic,  the  operation  would  appear  to  be 
fully  justified.  It  would  be  contra-indicated  in  all  advanced  cases, 
in  which  the  prostate  was  the  seat  of  active  suppuration  with  dis- 
charge into  the  urethra,  in  cases  complicated  by  urethritis,  cystitis 
or  nephritis,  in  cases  in  which  there  is  marked  prostration  from 
sepsis  or  absorbed  toxins,  and  generally  in  old,  worn  out  and 
cachectic  animals. 

Short  of  this,  in  cases  complicated  by  cystitis,  antiseptics  by 
the  stomach  and  as  injections  into  the  bladder  are  desirable. 
Eucal5rptol  in  doses  of  ten  minims  four  times  a  day,  or  piper- 
azin  15  grs.,  or  beta  naphthol,  guaicol,  or  phenol  have  been 
used  in  man.  As  injections  mercuric  chloride  i  :  20,000  ;  boric 
acid,  saturated  solution  ;  or  carbolic  acid  .5  :  100  (Lydston)  may 
be  used  warm  several  times  a  day. 


TUBERCULOSIS  OF  THE  PROSTATE. 

This  is  a  common  seat  of  tubercle  in  generalized  tuberculosis 
in  cattle,  and  may  give  rise  to  the  same  urinary  troubles  as 
chronic  prostatitis  or  hypertrophy  of  the  organ.  In  a  remarkable 
case  recorded  by  Frauenholz  the  tuberculous  prostate  of  an  ox 
weighed  io>^  lbs.  and  had  contracted  adhesions  to  surrounding 
pelvic  organs.  Section  of  the  mass  showed  numerous  centres  of 
extensive  caseous  degeneration.  In  such  cases  the  generalized 
tuberculosis  is  the  important  fact  and  the  prostatic  disease  is  only' 
an  unusually  intractable  complication.  If  less  generalized,  the 
implication  of  the  testicle  or  epididymus  is  strongly  suggestive, 
and  examination  of  the  urine  may  detect  the  tubercle  bacillus,  or 
the  tuberculin  test  may  develop  the  characteristic  febrile  reaction. 


CANCER  OF  THE  PROSTATE. 

Lafosse  records  as  colloid  cancer  a  case  of  diseased  prostate  in 
an  ox,  in  which  the  mass  approximated  to  the  size  of  the  human 
head,  and  was  made  up  of  numerous  cavities  the  largest  not 
over  lyi  inch  in  diameter,  and  all  intercommunicating,  and  con- 
taining a  gluey,  or  gelatinoid  liquid  with  numerous  small  round 
cells  and  a  few  multinucleated  giant  cells.  No  evidence  is  given 
of  the  implication  of  even  the  adjoining  lymph  glands,  so  that 
the  case  was  probably  only  an  enlarged  cystic  prostate. 

Fournier  records  a  case  in  a  three  year  old  horse,  which  on 
necropsy  showed  a  ruptured  bladder,  general  peritonitis,  and  an 
enlarged  prostate,  involving  Cowper's  glands.  Nocard  identified 
its  cancerous  nature  by  microscopic  examination.  Yet  there  is 
not  a  word  of  the  implication  of  adjacent  lymph  glands. 

Goubaux  says  prostatic  cancer  is  common  in  dogs. 


PROSTATIC  CYSTS. 

These  are  not  at  all  uncommon  as  a  complication  of  hjrper- 
trophy  of  the  prostate,  the  ducts  having  become  obstructed  and 
the  follicles  indefinitely  distended.  The  case  described  by 
Lafosse  as  cancer  of  the  prostate  of  a  bull  is  strongly  suggestive 
of  such  retention  cysts. 


CALCULUS  OF  THE  PROSTATE. 

Two  forms  of  calculi  have  been  found  in  the  prostate  in  do- 
mestic animals :  ist,  small,  round,  angular  or  branched  bodies 
made  up  in  concentric  layers  and  formed  of  organic  nitrogenous 
bodies:  and  2nd,  genuine  calculi  of  calcium  phosphate  or  am- 
monia magnesian  phosphate.  These  may  cause  pressure  on  the 
parenchymatous  tissue  and  atrophy,  but  in  the  lower  animals 
they  are  seldom  the  direct  cause  of  prominent  morbid  symptoms. 
280 


Diseases  of  the  Female  Generative  Organs.  281 

They  must,  however,  be  recognized  as  one  of  the  causes  of 
chronic  irritation  that  contribute  to  prostatic  inflammation  and 
hypertrophy. 


DISEASES  OF  THE  FEMALE  GENERATIVE  ORGANS. 

MALPOSITION  OF  OVARY  AND  WOMB.      HERNIA  OP  THE   OVARIES. 

Inguinal  or  crural  hernia  of  ovary  or  womb.  Bitch.  Long  uterine  borns, 
loose  broad  ligaments  ;  Sow  ;  Bwe  ;  Cow.  Other  openings.  Symptoms  :  not 
marked  :  strangulation  :  inflammation  :  abscess.  Gravid  hernial  uterus. 
Treatment :  reduction  :  surgical  means :  Caesarian  section. 

The  most  common  displacement  of  the  ovary  in  the  lower  ani- 
mals is  through  the  inguinal  or  crural  arch.  It  is  most  frequent 
in  the  bitch  doubtless  for  the  reason  that  the  horns  of  the  womb 
are  long,  and  widely  separated  from  each  other,  and  in  any  case 
of  inguinal  or  crural  hernia,  or  of  undue  dilatation  of  the  openings 
they  are  liable  to  pass  through.  A  relaxation  of  the  broad  lig- 
aments is  another  condition  of  such  displacement.  The  laxity  of 
these  ligaments  in  the  normal  condition  in  the  sow  favors  ovarian 
hernia,  and  Dupont  found  the  ovaries  in  the  perineal  region  in 
five  sows  examined,  I^aux  found  the  condition  in  ewes,  and 
Mtiller  in  cows,  one  ovary  lying  on  each  side  of  the  mammae. 
With  relaxation  of  the  uterine  ligaments  the  hernia  might  occur 
in  any  female  mammal,  and  not  only  through  the  orifices  named, 
but  through  any  normal  or  adventitious  opening  in  the  abdominal 
walls. 

Symptoms.  In  the  bitch  the  hernia  is  often  overlooked  although 
an  examination  of  the  inguinal  region  will  reveal  the  presence  of  a 
small  nodule  and  vermiform  body  which  may  usually  be  returned 
into  the  abdominal  cavity.  In  some  cases  it  becomes  strangulated 
by  the  gradual  contraction  of  the  neck  of  the  hernial  sac,  followed 
by  swelling,  heat  and  tenderness  of  the  hernial  mass,  which  may 
go  on  to  abscess  formation.  In  exceptional  cases  impregnation 
occurs  with  the  womb  in  this  position  and  the  steady  nodular  in- 
crease of  the  mass,  and  finally  the  automatic  movements  of  the 
contained  foetuses  become  very  characteristic. 

Treatment  consists  in  passing  the  womb  and  ovary  back  into 
the  abdomen,  and  if  adherent  or  incarcerated,  in  exposing  and 


282  Veterinary  Medicine, 

releasing,  and  if  necessary  extirpating  them.  In  case  of  advanced 
pregnancy  with  the  gravid  womb  on  the  inner  side  of  the  thigh, 
a  modified  Caesarian  operation  is  required  without  the  attendant 
danger  of  laying  the  peritoneal  cavity  directly  open.  Inflamma- 
tion and  abscess  must  be  treated  on  general  principles. 


UNDEVELOPED  OVARIES.  ABSENCE  OF  OVARIES. 

The  absence  of  ovaries  has  been  often  noticed  in  twin  heifers, 
and  most  commonly  associated  with  deficiency  or  absence  of  the 
womb,  and  even  at  the  anterior  part  of  the  vagina.  The  condi- 
tion is  especially  common,  though  not  constant  as  some  have 
supposed,  when  the  other  twin  is  a  male.  Such  females  are 
known  zsfree  martins  and  fail  to  breed.  Even  when  the  ovaries 
are  present  in  such  twins  they  remain  undeveloped,  and  are  no 
larger  than  a  bean  or  hazel  nut.  These  usually  have  a  firm, 
fibrous  structure,  and  though  there  may  be  interspaces  filled  with 
a  transparent  fluid,  no  true  Graafian  follicles  are  formed.  In 
birds,  the  left  ovary  only  is  developed  and  physiologically  active. 
The  absence  of  ovary  has  been  noted  also  in  the  ewe,  and  less 
frequently  in  the  mare  and  other  species,  and  appears  to  be  more 
common  in  twins  than  in  single  pregnancy.  In  cattle  only  has 
the  influence  of  the  male  on  the  female  twin  of  the  same  preg- 
nancy been  specially  noted. 

It  has  been  noted  that  females  with  ovaries  undeveloped,  tend 
to  show  many  male  characters,  in  head,  horns,  and  neck  in  cattle, 
in  plumage  in  birds,  and  in  voice  in  both. 


ATROPHY  OF  OVARIES. 

This  is  observed  as  a  physiological  result  of  having  passed  the 
breeding  age,  and  may  also  take  place  from  disease  and  degene- 
ration of  the  organ.  The  fibrous  stroma  is  usually  increased  and 
the  cell  elements  reduced,  yet  in  some  cases,  a  cystic  develop- 
ment occurs,  giving  the  appearance  of  hypertrophy,  while  the 
ovarian  parenchyma  has  actually  been  diminished. 


SUPERNUMERARY  OVARIES. 

Extra  ovaries  have  been  found  in  different  cases  in  the  human 
female,  the  additional  organ  being  furnished  with  a  fallopian 
tube,  and  in  some  instances  an  extra  uterine  horn.  No  facts  are 
at  hand  concerning  the  lower  animals,  but  the  occurrence  of  ges- 
tation and  the  birth  of  a  single  puppy  a  year  after  careful  castra- 
tion, would  seem  to  suggest  that  the  condition  occurs  in  the  bitch. 
There  is  no  embryological  reason  why  the  lower  animals  should 
not  at  times  show  this  deviation  from  the  normal. 


IRRITABLE  OVARY.     NEURALGIA   OF  THE  OVARY. 

This  has  been  noticed  most  cojoimonly  in  the  mare,  which 
from  a  quiet,  docile  animal,  has  become  very  ticklish,  especially 
in  the  region  of  the  flank,  kicking  on  the  slightest  touch,  or 
even  when  approached  and  showing  an  amount  of  nervous  ap- 
prehension, that  may  render  her  useless,  for  work.  The  ovaries 
are  usually  found  to  be  enlarged,  diseased  and  very  sensitive. 
CEstrum  may  be  in  some  cases  constant  and  excessive  and  in 
others  entirely  suspended.  Such  cases  are  diflScult  or  dangerous 
to  shoe.  In  one  case  recorded  by  Thierry,  handling  of  the  flank 
promptly  induced  an  epileptic  attack.  Cows  with  nympho-mania 
(bullers)  are  often  victims  of  this  condition.  The  only  remedy 
is  castration,  which  is  best  performed  by  the  vagina.  The  shorter 
the  period  of  the  irritability  the  more  perfect  is  the  cure.  In 
some  old  standing  cases  the  vicious  habit  may  have  become  so 
fixed,  that  it  is  continued  in  spite  of  the  operation. 


283 


HEMORRHAGE  ON  THE  OVARY. 

Mare  and  Cow :  genital  excitement,  mechanical  injury,  diseased  ovary  in 
nnimpregnated,  ovulation  with  bleeding,  falls/  slings.  Lesions  :  old  de- 
generations, productive  inflammation,  varicosities,  aneurisms,  torpid  vessels, 
blood  staining,  clots,  follicular  or  not,  ruptures  into  peritoneum,  amount, 
microbes  usually  absent.  Symptoms  :  obscure,  arched,  stiff  loins,  colics, 
recumbency,  large  tender  ovary.  Shivering,  fever,  anorexia,  anemia,  sur- 
face coldness,  unsteadiness,  blood  from  vulva,  liquid  in  abdomen  fluctuates. 
Treatment :  cold,  ice,  snow,  on  loins,  cold  acid  drinks,  tannin,  iron  chloride, 
matico,  gelatine  subcutem,  atropin,  ergotin,  viburnum,  derivatives,  castra- 
tion. 

This  has  been  seen  in  the  mare  and  cow  especially  in  connec- 
tion with  genetic  excitement  and  mechanical  injuries,  and  more 
especially  pre-existing  disease  of  the  ovary.  Trasbot  notes  that 
it  has  always  been  in  the  absence  of  pregnancy,  a  fact  which  we 
can  easily  explain  on  the  grpund  that  most  active  diseases  of  the 
ovary  render  the  animal  barren.  Gestation  like  castration,  calms 
the  genetic  instincts,  and  prevents  the  recurrence  of  oestrum  with 
its  vascular  excitement,  general  and  ovarian,  which  characterizes 
the  nnimpregnated  condition.  The  normal  rupture  of  the 
Graafian  follicle  and  escape  of  the  ovum  is  attended  by  some 
effusion  of  blood  which  passes  through  a  series  of  changes  pre- 
paratory to  absorption.  A  more  extensive  bleeding,  at  the  time 
of  oestrum  or  othervsdse,  into  a  follicle  or  intrafoUicular,  and  with 
or  without  rupture  of  the  albugenic  tunic  constitutes  the  morbid 
haemorrhage.  Among  mechanical  causes  may  be  named  violent 
exertion,  falls,  and  suspension  in  slings. 

Lesions,  Some  cases  in  mares  and  cows  show  old  standing 
lesions,  to  which  the  extravasation  is  secondary :  a  productive 
inflammation  of  the  ovarian  stroma ;  varicosity  of  the  ovarian 
veins ;  aneurism  of  the  utero-ovarian  artery ;  the  presence  of 
emboli  or  thrombi.  In  the  area  of  the  effusion  there  is  a  general 
turgescence  of  the  vessels,  and  blood  staining  of  the  stroma.  Or 
there  are  distinct  blood  clots  in  the  follicles  or  between  them,  a 
few  lines  or  an  inch  in  diameter,  buried  in  the  depth  of  the 
organ,  or  standing  out  in  rounded  swellings  on  its  surface,  and 
sometimes  with  a  rupture  two  or  three  inches  in  length,  and  the 
284 


HtEtnorrhage  on  the  Ovary,  285 

escape  of  blood  into  the  peritoneal  cavity.  This  may  be  sufficient 
merely  to  stain  the  peritoneal  fluid,  or  it  may  amount  to  one  or 
two  bucketfuls  as  in  cases  recorded  by  Barrow  and  Palat.  In 
the  absence  of  rupture  the  effused  blood  may  completely  surround 
the  ovary,  or  may  accumulate  in  one  or  several  of  its  distended 
follicles.  The"  effused  blood  is  rarely  septic,  being  usually  free 
from  microbes,  and  it  may  remain  fluid  in  the  peritoneum,  or 
coagulate  in  the  ovary.  The  enlarged  follicle  may  contain  a 
dark  red  fluid,  in  which  floats  a  solid  clot,  varying  in  color  from 
dark  red  to  light  yellow,  according  to  age. 

Symptoms,  These  vary  greatly  with  the  extent  of  the  lesion, 
and  are  always  somewhat  obscure.  With  slight  interstitial  or 
intra- follicular  effusion,  there  may  be  only  some  general  disorder, 
with,  it  may  be,  arching  and  stiffness  of  the  loins,  colicy  pains, 
a  desire  for  recumbency,  and  enlargement  and  tenderness  of  the 
ovary  on  rectal  examination.  In  more  severe  cases  as  noticed 
by  Cordonnier,  Saucour  and  Palat  in  mares,  by  Lapons^e  in  the 
ass,  and  Renault  in  the  cow,  there  were  shivering,  h5T)erthermia, 
respiratory  and  cardiac  acceleration,  congested  mucosae,  dull 
colicy  pains,  and  anorexia,  followed  by  indications  of  anaemia, 
small,  weak,  rapid  pulse,  pale  mucosae,  coldness  of  ears  and  legs 
(in  cows,  of  muzzle  and  horns),  violent  heart  action,  indisposition 
or  inability  to  rise,  unsteadiness  on  the  limbs  when  up,  and  in 
some  cases  the  escape  of  blood  from  the  vulva.  By  rectal  ex- 
amination the  enlarged,  tender,  doughy  ovary  may  be  character- 
istic and  the  fluctuation  of  liquid  in  the  peritoneal  cavity,  which 
may  also  be  recognized  by  manipulation  of  the  flank. 

Treatment,  This  should  be  directed  toward  checking  the  haem- 
orrhage :  Cold  water  or  ice,  on  loins  or  flank  ;  injections  of  cold 
water  :  cold  water  or  acids  or  astringents  by  the  mouth  :  tannic 
acid  :  iron  chloride  :  matico  :  gelatine  :  atropine,  ergotin.  By  way 
of  quieting  ovarian  excitement,  viburnum  prunifolium  or  opium 
may  be  tried.  Sterilized  solutions  of  gelatine  may  be  given  sub- 
cutem.  Mustard  or  ammonia  may  be  applied  to  limbs  or  flank. 
In  case  of  survival,  castration  will  be  indicated. 


INFLAMMATION  OF  THE  OVARIES.  OOPHORITIS. 
PERIOOPHORITIS. 

Mares,  cows,  sows,  etc.  Causes  :  traumas,  cestnun,  parturition,  leucor- 
rhoea,  pus  infection,  strangles,  dourine,  glanders,  abortion,  tuberculosis, 
chill,  poisons.  I,esions :  Ovary  enlarged  unequally,  red,  congested,  exu- 
date, extravasations,  fibroid,  caseated,  purulent,  abscess  single  or  multiple, 
indurations,  cretefactions,  cysts,  blocking  of  .Fallopian  tube,  adhesions. 
Symptoms  :  mare  :  genital  erethism,  soiling  of  vulva  and  tail,  colks,  tender 
loins  and  mammse :  fever,  dullness,  emaciation,  decubitus,  paraplegia, 
swollen  tender  ovary :  cow  bellows,  paws.  Sterility,  anaemia,  pyaemia. 
T/eatment :  Cold  to  croup,  mustard,  anodynes  to  vagina,  calmatives  anti- 
septics.   Castration. 

This  has  been  frequently  seen  in  mares,  cows  and  sows,  but  it 
may  occur  in  any  of  the  female  mammals  or  even  in  birds. 

Causes,  The  condition  has  been  ascribed  to  blows  on  the  flanks, 
pressure  on  the  abdomen  and  the  congestion  of  the  ovary  which 
attends  on  frequent  oestrum  in  the  absence  of  the  physiological 
quiet  which  comes  from  conception.  In  a  large  proportion  of  the 
cases,  however,  the  attack  has  followed  on  parturition,  abortion, 
a  preexisting  leucorrhoea  or  metritis,  or  a  suppurating  process 
in  some  other  part  of  the  body.  These  cases  therefore,  must  be 
looked  upon  as  secondary  and  infective,  the  microbes  having  been 
transferred  from  the  womb,  along  the  Fallopian  tubes,  or  through 
lymph  vessels,  or  peritoneal  cavity,  or  finally  through  the  circu- 
lating blood.  In  mares  strangles,  abortion,  leucorrhoea,  dourine 
and  glanders,  and  in  cows  and  sows  abortion,  metritis,  leucor- 
rhoea, and  tuberculosis,  may  prove  the  starting  point  of  the  in- 
fection. 

Sudden  chills  when  heated,  perspiring  or  exhausted  and  es- 
pecially exposure  in  inclement  weather  just  before  or  after  par- 
turition, have  been  regarded  as  effective  causes,  and  doubtless 
these  lower  vitality  and  power  of  resistance,  but  back  of  these  we 
must  look  for  infection  coming  from  the  parturient  womb. 

Bivort  records  an  extensive  epizootic  of  oophoritis  in  sows  kept 
on  waste  ground  which  had  been  used  for  herding  swine  years 
before.  He  attributes  the  trouble  to  poisonous  plants,  without, 
286 


Inflammation  of  the  Ovaries,     Oophoritis,     Perioophoritis,    287 

however,  attempting  to  identify  them,  and  the  probability  is  even 
more  strongly  in  favor  of  infection  left  over  from  the  former 
herds. 

Lesions,  The  inflamed  ovary  is  swollen  slightly,  or  to  a  great 
size,  in  mare  or  cow  like  the  fist  or  even  an  infants'  head.  The 
swelling,  however,  is  unequal  throughout,  and  the  surface  may 
bulge  in  rounded  masses  at  different  points.  In  the  early  stages 
the  organ  is  firm,  elastic,  red  and  on  the  cut  surface  bleeding, 
with  here  and  there  a  distended  follicle  with  bloody  or  gelatinoid 
liquid  contents.  The  exudate  into  the  fibrous  stroma  may  be- 
come coagulated,  and  later  may  be  organized  into  fibrous  sub- 
stance giving  a  hard  resistant  sensation  to  the  finger  (sclerosis). 
In  some  cases  this  may  become  partly  cartilaginous.  In  other 
cases  the  distended  follicles  may  have  their  contents  coagulated 
and  transformed  into  a  caseous  mass,  while  much  of  the  stroma 
has  become  liquefied  and  absorbed.  When  suppuration  has  set 
in,  the  gland  is  softened  at  this  point,  the  parenchyma  giving 
way  before  the  pus.  The  pus  may  be  in  multiple  sacs,  as  if 
formed  in  the  Graafian  vesicles,  or  it  may  be  in  one  undivided 
abscess.  In  the  ovary  of  a  cow,  El^ouet  counted  no  less  than 
sixty-three  separate  abscesses.  In  cases  complicated  by  ovarian 
glanders,  tuberculosis  or  actinomycosis,  the  gross,  microscopic, 
and  mycotic  characters  of  the  lesions  will  afford  the  means  of 
diagnosis. 

In  chronic  forms  indurations,  cretefactions,  cystic  degenera- 
tions, caseations,  and  sclerosis  may  be  met  with. 

Lesions  in  adjacent  structures  are  common,  such  as  thickening 
and  stenosis  of  the  Fallopian  tube ;  congestion,  thickening  and 
puckering  of  the  mucosa  in  the  adjacent  part  of  the  womb  ;  peri- 
tonitis ;  adhesions  of  the  ovary  to  the  abdominal  walls  or  to  an 
adjacent  organ. 

Symptoms,  Mare,  In  many  cases  the  early  phenomena  are 
those  of  excessive  genital  erethism  :  the  animal  is  restless,  fever- 
ish, whinnies  to  attract  other  horses,  snuffs  the  males  on  their 
approach,  contracts  the  vulvar  muscles  constantly,  exposing  the 
congested  mucosa  and  clitoris,  and  ejecting  a  glairy  liquid  which 
soils  the  tail,  hips,  thighs  and  hocks.  She  strains  frequently, 
passing  small  jets  of  high  colored  turbid  urine,  and  rubs  the  tail 
and  hips  against  available  objects,  twisting  and  breaking  the  hair 


288  Veterinary  Medicine, 

and  abrading  and  excoriating  the  surface.  The  croup  may  be 
alternately  drooped  and  raised  and  the  tail  switched.  These  phe- 
nomena are  not  abated  by  copulation,  nor  by  time,  like  ordinary 
heats,  but  will  last  for  one  or  more  weeks  when  a  new  set  of 
symptoms  set  in.  Meanwhile  dull  colicy  pains  cause  restless 
movements,  arched  back,  frequent  moving  from  place  to  place, 
crouching  by  partial  bending  of  the  limbs,  twisting  of  the  hind 
parts  from  side  to  side.  The  loins  are  tender  to  pressure,  and  the 
middle  of  the  flank  to  pressure  or  percussion.  The  mammary 
glands  are  usually  hot,  swollen  and  tender.  The  genital  erethism 
may  last  from  four  to  seven  days.  Then  it  subsides,  with  coinci- 
dent improvement  of  the  general  symptoms  and  a  recovery  ensues. 
Relapses  are  to  be  expected  sooner  or  later. 

In  fatal  cases  the  erethism  subsides,  but  fever,  dullness  and 
emaciation  continue,  the  case  becomes  aggravated  at  intervals, 
weakness  and  exhaustion  increase,  decubitus  may  become  con- 
stant or  paralysis  ensue.  The  patient  dies  in  marasmus  in  one  to 
three  months. 

In  some  the  genital  erethism  is  absent  from  the  first.  There  is 
dullness,  prostration,  anorexia,  fever,  hurried  breathing,  small 
rapid  pulse,  colicy  pains,  tender  abdomen,  difiBcult  defecation, 
coated  dung,  a  glairy  (perhaps  reddish  or  fcetid)  discharge  from 
the  vulva,  hot,  tumid,  tender  mammae,  arched  and  sensitive  loins, 
and  stiffness  of  the  hind  limbs. 

In  all  cases  alike  a  rectal  examination  detects  the  ovary  swollen 
and  exceedingly  tender. 

Cow.  The  same  general  symptoms  appear  with  characteristic 
modifications.  Restlessness,  bellowing,  pawing,  inappetence, 
arched,  tender  loins,  swollen  vulva  with  discharge,  shiny  and 
perhaps  fcetid  but  without  contractions,  abdomen  pendent  and 
flanks  hollow  and  tender,  udder  lurgid,  hot  and  painful,  move- 
ments of  the  hind  limbs  stiff,  halting,  straddling.  There  is 
greater  tendency  to  salacious  movements  of  the  croup.  The 
diagnostic  feature  is  palpation  of  the  ovary  through  the  rectum. 

In  chronic  cases  more  or  less  of  the  above  symptoms  are  shown 
in  a  greatly  mitigated  form,  but  oftentimes  there  are  long  inter- 
vals of  apparent  health.  Palpation  through  the  rectum  is  the 
final  test  in  this  as  in  the  more  acute  cases. 


Ovarian  Cysts,  289 

Prognosis,  This  is  very  uncertain.  Unless  complete  recovery 
takes  place  in  a  few  weeks,  the  inevitable  consequence  is  sterility, 
or  death  from  haemorrhage,  peritonitis,  pyaemia,  marasmus. 

Treatment,  In  acute  cases  Trasbot  strongly  urges  bleeding  in 
the  larger  races  and  leeching  of  the  flanks  in  the  smaller.  Mus- 
tard plasters  to  the  loins  and  abdomen,  and  cold  or  damp  appli- 
cations to  the  croup  are  in  order.  Vaginal  and  rectal  injections 
of  mucilaginous  liquids,  containing  anodynes  and  antiseptics  are 
indicated.  Opium,  belladonna,  hyoscyamus,  chloral,  borax,  ace- 
tate of  aluminium  may  serve  as  examples.  If  needful  to  quiet 
the  excitement,  morphia,  atropia  or  hyoscyamin  may  be  given 
subcutem.  Or  the  anodynes  may  be  administered  by  the  mouth. 
As  a  last  resort,  and  by  far  the  most  radical  treatment,  castration 
may  be  performed.  With  small  ovaries  this  is  best  done  through 
the  vagina  in  the  larger  animals,  while  with  large  and  adherent 
ones  the  flank  operation  is  imperative.  If  the  peritoneum  is  in- 
volved, careful  antisepsis  of  the  cavity  is  desirable.  In  case  of 
adhesions  the  operation  may  be  risky,  but  if  successful  it  will 
obviate  secondary  infections  and  establish  a  permanent  cure. 
Complications  must  be  treated  according  to  their  nature. 


OVARIAN  CYSTS. 


Mare,  cow,  ewe,  sow,  bitch,  hen.  Forms  Histogenesis.  Dilated  vesicles, 
egg  tubes,  blood  obstruction.  Lesions  :  Ovary  large,  smooth,  lobulated, 
vascular,  size,  connective  tissue,  epithelium,  liquid  contents.  Abscess. 
Symptoms :  impaired  portal  circulation,  muco- enteritis,  piles,  intestinal 
torpor,  impaction,  constriction,  obstruction,  congestions,  inflammation. 
Urinary  disorder.  Strangulation.  Sterility.  Abortion.  Dystokia.  Indigestion. 
Anorexia.  Colic.  Genital  erethism.  Straining.  Altered  Urine.  Peritonitis. 
Septic  infection.  Collapse.  Rectal  palpation,  enlarged,  sensitive  ovary. 
Treatment :  Castration.    Tapping  cyst.     Rupturing  cyst  by  compression. 

These  have  been  met  with  in  all  races  of  domestic  animals, 
mare,  cow,  ewe,  sow,  bitch  and  hen.  They  vary  greatly  in 
their  characters,  being  unilocular,  multilocular,  rounded  or 
lobulated,  serous,  albuminous,  colloid,  or  haemorrhagic,  strictly 
ovarian  or  parovarian  (in  broad  ligaments),  in  one  ovary  or  in 
both. 

19 


290  Veterinary  Medicine, 

Histogenesis,  The  source  of  these  cysts  has  been  much  debated. 
Many  have  held  with  Spencer  Wells  that  they  have  their  origin 
in  dilated  Graafian  vesicles,  and  the  discovery  of  an  ovum  in 
the  contents,  by  Rokitansky  and  Ritchie  showed  at  least  that 
this  follicle  had  formed  part  of  the  cyst.  On  the  other  hand 
Foster,  Rivolta,  Klebs,  Malassez  and  others,  constantly  failed 
to  find  ova  or  other  distinct  elements  of  the  Graafian  follicles, 
but  did  not  find  epithelial  elements,  and  note  that  the  cysts  are  at 
an  early  stage  connected  with  the  surface  of  the  ovary  like  the 
egg  tubes.  These  embryonic  tubules  of  Pflueger  are  therefore 
held  to  be  the  starting  point  for  the  cysts,  which  because  of  their 
mixed  epithelial  as  well  as  liquid  contents,  seem  allied  to  adenoma. 
From  observations  on  the  ovarian  cysts  of  the  lower  animals 
Galtier,  attaches  great  importance  to  vascular  obstructions.  Ob- 
struction by  pressure  or  otherwise  led  to  haemorrhages  and 
transudation  of  blood,  and  the  cavities  formed  in  this  way  be- 
came the  seats  of  epithelial  growth,  and  liquid  effusion.  The 
blood  remained  for  a  time  as  distinct  clots,  and  was  later  indi- 
cated by  the  pigmentation  of  the  walls  of  the  cyst. 

Lesions,  The  enlarged  ovary  may  be  uniformly  rounded  and 
smooth,  or  it  may  be  marked  by  irregular  bosses,  giving  it  a 
lobulated  appearance.  It  is  very  vascular,  and  is  often  covered 
by  a  thickening  of  peritoneum.  When  multiple  they  are  usually 
closely  adherent  and  may  even  be  included  one  within  another. 
The  individual  cysts  may  be  of  the  most  varied  sizes.  The  cystic 
ovary  has  at  times  reached  enormous  dimensions  :  in  the  mare  46 
lbs.  (Bouley,  Rivolta,  Thiernesse)  :  in  the  cow  250  lbs.  (Rey- 
nolds, Meyer):  in  the  ewe  7  lbs.  (Willis):  in  the  sow  7  Ibo. 
(Reyer) :  in  the  bitch  15  lbs.  (Bovett).  The  walls  of  the  cyst  are 
formed  of  connective  tissue  more  or  less  perfectly  organized,  ar- 
ranged it  may  be  in  several  superposed  layers  (Galtier)  and  lined 
or  not  by  epithelial  cells  (cylindroid,  nucleated,  or  of  various 
forms).  They  may  be  reddened  by  haemorrhages  or  pigmented 
from  former  blood  extravasations.  The  liquid  contents  may  be 
clear  and  watery,  white,  straw  yellow,  or  of  a  deeper  yellow, 
brown  or  red.  Among  other  constituents  there  are  alkaline 
chlorides  and  sulphates,  albumen  in  solution  or  fiakes,  mucin, 
fibrine,  fatty  granules  and  cholesteriue  cystals.  In  some  instances 
they  contain  pus  cells  (chronic  abscess). 


Ovarian  Cysts,  291 

Symptoms.  Small,  tardily  growing  cysts  may  cause  no  ap- 
preciable symptoms.  The  larger  ones  or  those  that  increase 
rapidly  are  liable  to  cause  disorders  of  circulation,  innervation 
and  digestion.  The  mere  pressure  of  a  considerable  cystic  ovary 
may  interfere  with  portal  circulation  so  as  to  entail  muco-enteri- 
tis,  rectal  congestion,  piles,  or  intestinal  torpor  or  impaction. 
Adhesions  of  the  diseased  ovary  to  adjacent  intestinal  viscera, 
tend  to  produce  constrictions,  obstructions  and  local  congestions 
or  inflammation.  In  adhesions  to  the  womb  or  bladder,  ureter 
or  kidney,  the  symptoms  will  indicate  disorder  of  these  respective 
parts.  The  weight  of  the  enlarged  ovary  causing  extension  of 
its  ligamentous  connections  will  allow  of  its  winding  around  a 
loop  of  intestine  and  producing  strangulation.  In  those  unusual 
cases  in  which  pregnancy  occurs  it  may  interfere  with  its  com- 
pletion, causing  abortion  or,  failing  in  this,  with  parturition, 
by  becoming  imbedded  in  the  pelvis.  In  the  line  of  innervation, 
disorder  is  especially  common  in  the  digestive  organs,  anorexia, 
nausea,  impaired  rumination,  and  colicy  pains  resulting.  Again, 
in  many  subjects  the  genesic  instinct  is  stimulated,  the  patient  is 
more  or  less  constantly  in  heat,  cows  become  bullerSy  and  mares 
switchers,  they  cannot  be  impregnated,  and  under  the  continuous 
excitement  undergo  rapid  emaciation.  There  is  often  urinary 
disturbance,  frequent  straining  with  the  passage  of  a  small  quan- 
tity only  of  turbid  or  glairy  liquid,  colored,  it  may  be,  by  blood, 
or  foetid.  The  colics  are  liable  to  be  dull  and  slight,  the  patient 
moving  uneasily,  switching  the  tail,  moving  the  weight  from  one 
hind  foot  to  the  other,  pawing,  looking  at  the  flank,  but  sel- 
dom lying  down  or  rolling.  In  other  cases,  with  adhesions, 
impactions,  obstructions,  and  congestions,  all  the  violent  motions 
of  the  most  intense  spasmodic  colic  may  be  shown.  Where  there 
has  been  rupture  of  the  obstructed  bowel,  these  symptoms  may 
merge  into  those  of  peritonitis,  septic  infection,  or  collapse.  When 
with  these  symptoms  of  intestinal  disorder,  there  are  tender  loins 
and  flank,  abdominal  plenitude  and  tension,  genital  excitement, 
frequent  straining  to  pass  urine,  the  discharge  of  a  glairy  or  foetid 
liquid,  and  when  all  these  symptoms  have  increased  slowly  for 
weeks  or  months  in  a  female,  the  ovaries  may  be  suspected  and  a 
rectal  examination  should  be  made.  Usually  the  outline  of  the 
womb  can  be  made  out  with  the  enlarged  and  irregularly  shaped 


292  Veterinary  Medicine, 

ovary  anteriorly  and  adherent  to  it  through  one  of  the  broad  lig- 
aments ;  it  may  be  sensitive  to  touch,  tense,  or  even  fluctuating. 
Difficulty  may  be  encountered  when  the  enlarged  ovary  is  so 
great  as  to  fill  the  whole  region,  or  when  adherent  to  or  wound 
round  the  rectum,  thus  hindering  the  advance  of  the  hand  or  the 
movement  of  the  gut,  or  when  it  has  become  pediculated  and  dis- 
placed to  a  distant  part  of  the  abdomen.  Even  the  obstructed 
and  distended  intestine,  may  prevent  a  satisfactory  diagnosis. 
Yet  in  the  great  majority  of  cases  rectal  examination  gives  con- 
clusive results. 

Treatment,  Medicinal  measures  are  useless :  surgical  alone 
are  of  any  avail.  Castration  is  the  natural  resort,  and  in  all  re- 
cent cases,  uncomplicated  by  adhesions,  is  to  be  preferred.  In 
the  large  females  it  may  often  be  performed  through  the  vagina, 
but  if  the  ovary  is  very  large  the  flank  operation  becomes  imper- 
ative. Sometimes  the  evacuation  through  a  cannula  of  the  con- 
tents of  one  or  more  large  cysts  will  so  reduce  the  mass  as  to 
allow  of  the  safer  vaginal  operation. 

A  less  radical  measure  is  the  evacuation  of  the  cyst  with  can- 
nula and  trochar  and  the  injection  of  tincture  of  iodine.  With  a 
hand  in  the  rectum  the  ovary  may  be  held  against  the  abdominal 
^vall  to  facilitate  the  operation.  The  results,  however,  are  not 
satisfactory,  for,  although  re-accumulation  of  the  liquid  is  delayed, 
it  is  not  entirely  prevented .  Moreover,  when  the  cysts  are  multiple, 
the  punctures  also  must  be  numerous,  or  remain  ineffective. 
Nor  is  the  operation  unattended  by  danger  as  deaths  often  occur 
from  resulting  inflammation,  infection,  or  iodine  poisoning. 

Zannger,  in  i860,  introduced  the  method  of  rupturing  the 
cyst  without  incision,  and  met  with  considerable  success.  With 
the  hand  in  the  rectum  the  cystic  ovary  is  pressed  against  the 
wall  of  the  pelvis  or  abdomen,  until  the  attenuated  wall  of  the 
cyst  gives  way,  the  fluid  is  left  in  the  abdominal  cavity,  to  be  ab- 
sorbed and  many  animals  will  afterward  become  pregnant.  In  a 
large  proportion  of  cases  in  which  the  symptoms  are  marked, 
the  walls  of  the  cyst  are  sufficiently  attenuated  to  allow  of  rup- 
ture by  pressure,  and,  if  the  escaping  contents  are  free  from  in- 
fecting microbes,  no  immediate  harm  comes  to  the  peritoneum. 
It  should  be  avoided  in  case  of  abscess,  following  perhaps  on 
a  shivering  fit  and  constitutional  febrile  reaction,  and  when  there 


Dermoid  Cysts  of  the  Ovary,     Pilous  Cysts.  293 

is  a  foetid  discharge  from  the  vulva,  suggesting  tnicrobian  infec- 
tion likely  to  dangerously  infect  the  serosa.  In  appropriate 
cases  it  is  a  resort  of  very  great  value,  in  restoring  to  use  ani- 
mals that  are  especially  valuable  for  their  progeny  and  which  be- 
come utterly  useless  when  rendered  barren.  According  to  different 
observers  an  average  of  70  per  cent,  'can  be  restored  to  usefulness 
in  this  way.  Friedberger  and  Frohner  claim  90  per  cent.  Some 
febrile  reaction  may  be  noted  for  twenty- four  hours  demanding 
rest,  restricted,  cooling,  laxative  food  and  sometimes  laxatives 
and  anodynes. 


DERMOID  CYSTS  OF  THE   OVARY.       PILOUS   CYSTS. 

Closed  cutaneous  sacs,  with  hair  and  sebum.  Causes  :  enclosure  of  der- 
moid tissue  in  embryo :  aborted  ovum :  virgin  gestation.  Symptoms. 
Treatment :  Castration. 

These  are  much  less  common  than  are  simple  cysts.  They  are 
closed  sacs,  lined  by  a  tissue  essentially  representing  skin,  and 
containing  sebaceous  matter  and  hairs,  some  growing  from  the 
dermoid  surface,  and  others  detached  and  formed  into  a  loose 
mass. 

Causes,  These  cysts  have  been*  attributed  to  the  enclosure,  in 
the  forming  embryo,  of  the  formative  elements  of  dermoid  tissue, 
which  may  or  may  not  remain  latent  and  inactive  until  maturity, 
or  until  the  ovary  becomes  physiologically  active. 

Another  theory  is  that  an  impregnated  ovum  has  remained  im- 
perfect, developing  only  the  elements  of  the  skin,  instead  of  the 
whole  foetal  body.  Many  cases  cannot  by  any  possibility  be  in- 
cluded under  this  head,  seeing  that  the  cyst  is  found  at  much  too 
early  an  age,  and  its  bearer  has  never  had  sexual  intercourse. 

Another  doctrine  is  that  the  dermoid  cyst  is  derived  from  the  nor- 
mal plastic  or  formative  powers  of  the  ovary,  and  the  product  be- 
comes suggestive  of  parthenogenesis  or  virgin  gestation.  The  fact 
that  these  cysts  are  not  confined  to  the  production  of  skin  and  hair, 
but  at  times  form  bone,  teeth,  nervous  and  other  tissues  as  well, 
corroborates  this  view.  On  the  other  hand  we  must  bear  in  mind 
that  dermoid  cysts  are  much  more  common  in  other  tissues  than 


294  Veterinary  Medicine. 

they  are   in  thfe  ovaries.     Thus  they  are  common  in  the  sub- 
cutaneous connective  tissue  and  between  the  muscles. 

The  symptoms  do  not  differ  essentially  from  those  of  simple 
cysts  and  treatment  is  mainly  by  castration.  As  the  escape  of  the 
contents  into  the  peritoneal  cavity  is  especially  provocative  of  in- 
fection, the  greatest  care  must  be  taken  to  extract  the  mass  whole, 
or  to  use  the  most  thorough  antiseptic  precautions. 


SOLID  OVARIAN  TUMORS. 

These  are  much  more  rare  than  cystic  tumors.  They  seldom 
maintain  the  character  of  perfect  solidity,  for  whether  fibrous, 
sarcomatous,  melanotic,  cretaceous,  myomatous,  cancerous, 
epithelial,  tubercular,  glanderous,  or  actinomycotic,  they  are 
usually  associated  with  the* cysts  to  a  greater  or  less  extent.  Not 
only  are  they  liable  to  stimulate  the  formation  of  cysts,  but  the 
special  heteroplasia  may  become  engrafted  on  the  walls  of  pre- 
existing cysts,  as  well  as  on  normal  tissues. 

The  symptoms  of  the  solid  tumors  are  in  the  main,  those  of  the 
cystic  form,  and  treatment  resolves  itself  into  extirpation  by 
castration.  Its  success  will  vary  according  to  the  nature  of  the 
tumor,  sarcoma,  melanoma  and  carcinoma  being  especially  liable 
to  recur  in  the  same  or  in  distant  situations,  and  the  same  is 
true  of  the  colonizing  with  infectious  germs  (glanders,  tuber- 
culosis, actinomycosis)  which  are  presumably  already  present 
in  other  parts  of  the  body.  Castration  has  however,  this 
recommendation,  it  secures  the  removal  of  the  entire  diseased 
organ,  and  if  the  morbid  process  or  infection  is  confined  to  that 
only,  it  holds  out  the  best  prospect  of  recovery. 


INFLAMMATION  OF  THE  FALLOPIAN  TUBES. 
SALPINGITIS. 

This  condition  is  met  with  in  the  female  mammals  of  all 
species  and  mainly  as  the  result  of  an  infection  extending  from 
diseased  womb  or  ovary.     The  results  are  degeneration  of  the 


Diseases  of  the  Oviduct  in  Birds.  295 

epithelium,  exudation  into  the  mucosa  with  thickening,  stenosis 
of  the  tubes,  the  formation  of  cysts  along  the  line  of  the 
canal,  with  pink  or  straw  colored  contents,  including  fibrine^ 
leucocytes,  epithelium  and  granular  debris.  As  in  oophoritis 
there  may  be  blood  extravasations  and  clots  and  abscess.  In 
the  cow  they  are  at  times  calcified  and  create  a  suspicion  of 
tuberculosis. 

The  symptoms  are  essentially  those  of  metritis  or  ovaritis, 
and  as  these  are  usually  more  prominent  the  attendant  sal- 
pingitis is  generally  overlooked  during  life.  Careful  rectal  ex- 
amination may  detect  the  enlarged,  tender  or  sacculated  tubes. 
Treatment  may  be  laxative,  diuretic,  derivative,  and  antiseptic 
toward  the  womb.  Ablation  of  the  ovaries,  tubes  and  even  the 
womb  is  often  required. 


DISEASES  OF  THE  OVIDUCT  IN  BIRDS. 

Imperforate  tube  near  cloaca.  Polypus  :  snare  and  twist  off.  Egg  im- 
paction: from  atony,  inflammation,  stricture,  congenital  smallness,  ex- 
haustion, large  eggs,  thick  end  first,  broken  egg.  Symptoms :  mopes 
alone,  feathers  erect,  wing  and  tail  drooping,  large,  solid  swelling  around 
anus  and  abdomen.  Rupture  into  abdomen.  Treatment  :  oil  cloaca  and 
oviduct,  manipulate,  turn,  break  egg  and  scoop  out,  incise  and  extract, 
antiseptic  oils.     Excision  of  ovary. 

Imperforate  oviduct  usually  occurs  in  the  lower  part  of  its 
course,  the  tube  being  connected  with  the  cloaca  by  a  short, 
fibrous  cord.  In  the  case  of  a  very  valuable  bird  it  may  be  in- 
cised and  the  walls  of  the  duct  may  be  brought  down  and  fixed 
to  those  of  the  cloaca. 

Polypi  of  the  oviduct  may  seriously  impede  laying,  and  start  ob- 
struction and  impaction.  The  seat  of  the  tumor  having  been  as- 
certained, it  may  be  seized  and  twisted  off  by  a  snare.  An 
elastic  wire  is  passed  through  a  small  metallic  tube  so  that  a  loop 
protrudes  large  enough  to  pass  over  the  poljrpus.  When  fixed 
around  the  pedicle,  it  is  tightened,  and  the  tissues  twisted  through. 

Egg  Impaction  in  the  Oviduct.  Prom  weakness  or  lack 
of  tone  in  the  bird,  by  inflammation  and  loss  of  contractile  power 
in  the  oviduct,  by  stricture  of  the  duct  as  a  sequel  of  inflamma- 


296  Veterinary  Medicine, 

tion  or  abrasion,  by  congenital  narrowing,  by  weakening  of  the 
oviduct  through  constant  laying,  by  excessive  size  of  the  ^%%y  by 
double  yolked  eggs,  by  presentation  of  a  large  ^%%  with  its  thick  end 
first,  or  by  an  egg  with  broken  shell,  the  oviduct  may  be  rendered 
incapable  of  passing  the  egg  on  and  out,  and  as  others  continue 
to  press  down  from  above  an  excessive  and  dangerous  impaction 
ensues.  The  bird  refuses  food,  mopes  around  with  ruffled  feathers 
and  drooping  head,  wings  and  tail.  The  region  of  the  anus  and 
in  front  of  it  hangs  downward  and  feels  firm  and  solid,  and  the 
oiled  finger  introduced  into  the  cloaca  comes  in  contact  with  the 
impacted  mass.  The  bird  strains  violently  but  ineffectually  and 
rubs  its  anus  on  the  ground.  The  swelling  goes  on  steadily  and 
rapidly  increasing,  and  the  bird  becomes  more  prostrate  and  hope- 
less. Sometimes  the  overdistended  and  congested  oviduct  gives 
way  and  the  eggs  escape  into  the  abdomen.  Reul  has  counted  as 
many  as  24  eggs  that  had  thus  escaped  into  the  abdominal  cavity. 
Or  without  rupture  of  the  oviduct,  the  soft  eggs  pack  together 
into  a  solid,  dry,  yolk-like  mass,  the  watery  parts  having  been 
pressed  out  or  absorbed.  In  bad  cases  this  may  weigh  i)^  lb.  in 
the  hen  (Weber) .  In  the  way  of  treatment  the  cloaca  and  oviduct 
should  be  thoroughly  lubricated  with  a  bland  oil,  which  might  be 
injected  with  a  syringe,  so  as  to  pass  it,  if  possible,  around  the 
impacted  egg  or  mass.  By  careful  manipulation  the  egg  may  now 
be  brought  away.  If  the  thick  end  is  presented  it  is  sometimes 
possible  to  turn  it  so  that  the  thin  end  will  come  first.  Should 
all  fail  the  egg  may  be  broken  and  its  contents  together  with  the 
other  impacted  matter  may  be  dislodged  with  a  looped  wire  or 
small  spoon.  The  oviduct  should  be  lubricated  for  some  time 
with  a  bland  antiseptic  oil  (olive  oil  and  boric  or  salicylic  acid). 
In  obstinate  cases  the  abdomen  and  oviduct  may  be  laid  open  and 
both  evacuated  of  any  egg  matter  that  may  be  present.  After 
suitable  antisepsis  the  wounds  in  the  oviduct  and  abdominal  walls 
are  to  be  sutured.  If  there  appears  to  he  danger  of  the  further 
early  descent  of  eggs  into  the  weakened  oviduct  the  ovary  may 
be  removed. 

Eversion  of  the  Oviduct,  This  appears  at  times  as  a  result  of 
the  intromission  of  the  penis  (ducks)  being  shown  immediately 
after  copulation  as  a  pink,  lax  membrane  one  or  more  inches  long, 
dragging  from  the  anus.     In  other  cases  it  appears  to  result  from 


Diseases  of  the  Oviduct  in  Birds.  297 

the  paresis  that  occurs  in  old  birds  from  prolonged  laying,  or 
from  inflammation  and  impactions.  It  may  appear  abruptly  or 
gradually,  and  after  a  few  hours  becomes  the  seat  of  exudation, 
swelling  and  redness,  forming  a  pyriform  mass.  In  some  cases 
it  is  carried  out  around  an  egg  which  does  not  glide  through  its 
canal  and  may  be  felt  through  its  walls,  and  through  its  terminal 
opening.  A  partial  eversion  may  take  place  as  an  invagination  into 
the  cloaca,  without  showing  externally.  When  an  egg  is  im- 
pacted, or  when  the  protruded  organ  is  inflamed  and  swollen, 
violent  straining  continues,  which  tends  to  aggravate  the  con- 
dition, and  the  bird  gets  rapidly  exhausted,  resting  on  its  breast, 
later  upon  its  back,  and  dying  in  convulsions. 

In  slight  cases  following  copulation,  the  vermicular  movement 
of  the  duct,  of  the  cloaca  and  anus  may  serve  to  secure  speedy 
spontaneous  reduction.  In  the  partial  cases,  of  eversion  into  the 
cloaca,  the  free  local  use  of  oil,  may  secure  the  passage  of  the 
presenting  egg  and  the  return  of  the  oviduct.  If  necessary  the 
egg  may  be  broken  and  its  shell  thoroughly  extracted.  This  last 
method  is  imperative  when  the  egg  enclosed  in  the  oviduct  has 
already  passed  through  the  anus.  The  ovidu(:t  should  then  be 
cleansed  in  tepid  water,  and  laudanum,  oiled  and  returned. 

Inflammation  of  the  oviduct  is  a  common  condition  resulting 
from  debility,  from  impaction  of  an  egg  or  of  egg-material,  from 
scratching  with  the  shell  of  a  broken  egg,  and  from  microbian 
invasion.  The  frequent  passage  of  large  eggs  is  an  accessory 
cause,  and  the  egg  becomes  an  important  factor  in  the  mainte- 
nance and  aggravation  of  the  inflammation.  The  mucosa  be- 
comes red,  dry,  infiltrated,  thickened  and  friable,  and  the  muscu- 
lar coat  increasingly  paretic.  The  egg,  becoming  impacted,  and 
subjected  to  constant  pressure  in  the  vain  efforts  at  expulsion, 
hinders  circulation  and  nutrition,  and  favors  necrotic  and  ulcera- 
tive processes,  and  too  often  the  fragile  membranous  walls  yield, 
and  the  mass  drops  into  the  abdominal  cavity.  Short  of  this, 
the  exudate  at  a  particular  point,  the  main  seat  of  inflammation, 
contracting  in  undergoing  organization,  forms  a  distinct  stricture, 
which  renders  the  further  la5dng  of  fully  formed  eggs  difficult  or 
impossible,  and  further  impaction,  inflammation  and  rupture  may 
follow.  Sometimes  the  irritation  causes  undue  peristalsis  in  the 
anterior  and  less  actively  inflamed  part  of  the  tube,  apd  the  eggs 


298  Veterinary  Medicine, 

are  laid  prematurely  without  albumen  or  without  shell,  yet  with 
much  effort  and  suffering.  Or  the  bowels  become  irritable  and 
a  profuse  diarrhoea  sets  in,  hastening  the  exhaustion  of  the 
patient. 

Treatment  should  be  applied  early.  A  cooling  diet  of  vege- 
tables or  slops,  the  careful  removal  of  all  irritating  contents 
from  the  oviduct,  and  its  frequent  injection  with  bland  oils  medi- 
cated with  mild  anti-septics  (boric  or  salicylic  acid,  or  potassium 
permanganate)  will  usually  serve  a  good  purpose. 


HYDROMETRA  AND  PYOMETRA. 

Cause :  chronic  metritis,  tumorp,  mtcrobian  infection.  Symptoms  :  ill- 
health,  low  condition,  vulvar  swelling  or  discharge,  swelling  and  flnctuation 
of  womb.  Rectal  exploration.  Treatment  :  evacuate  liquid,  disinfect 
womb  an«1  passages.  creoHn,  iodine. 

As  a  rule  these  conditions  belong  to  obstetrics  and  would  not 
come  under  the  scope  of  this  volume,  but  when  in  chronic  cases, 
with  closure  of  the  neck  of  the  womb,  the  liquids  accumulate  and 
distend  the  uterus,  they  may  deserve  mention  in  a  medical 
work. 

.  The  cause  is  usually  a  chronic  metritis,  originating  it  may  be  at 
the  time  of  a  now  distant  parturition,  or  associated  with  tumors 
or  microbian  invasions  of  the  womb.  In  the  deadly  cases  that 
follow  upon  parturition  and  abortion  streptococcus  is  usually 
present,  in  the  more  chronic  forms  the  staphylococcus  or  other 
pus  microbe. 

The  symptoms  are  those  of  general  ill-health,  low  condition, 
pallor  of  the  visible  mucosae,  sometimes  swelling  of  the  vtdva 
with  discharge,  serous  or  purulent,  lessened  milk  yield,  enlarge- 
ment of  the  abdomen  with  fluctuation  felt  in  the  right  flank,  or 
still  better  with  the  hand  in  the  rectum.  Rectal  exploration  will 
further  detect  the  distended  uterus  connected  with  the  vagina 
behind  and  dividing  in  front  into  two  horns. 

Treatment  consists  in  the  evacuation  of  the  liquid  through  a 
catheter  or  cannula  introduced  through  the  os,  or  through  the 
vaginal  wall  immediately  above,  followed  by  a  systematic  disin- 


Uterine  Tumors.  299 

• 

fection.  By  placing  the  patient  upon  her  back,  gravitation  of  the 
liquid  is  more  marked,  but  when  this  is  not  convenient  it  may  be 
done  with  the  animal  standing.  The  flow  may  be  favored  by 
raising  the  abdomen  with  a  sheet  held  by  two  assistants.  The 
womb  may  be  thoroughly  cleansed  by  a  normal  salt  solution 
which  has  been  boiled,  and  then  daily  injected  with  a  creolin 
solution  (i  :  100).  In  hydrometra  an  iodine  lotion  may  be  used, 
A  course  of  tonics  is  often  indicated. 


UTERINE  TUMORS. 

These  are  somewhat  rare  in  the  domestic  animals,  yet  they  have 
been  met  with  in  the  form  of  cysts,  fibroma,  fibro-myoma,  sar- 
coma, and  carcinoma.  In  a  number  of  cases  the  nature  of  the 
tumor  has  not  been  clearly  made  out.  Mangot  saw  a  mare  with 
two  pediculated  uterine  tumors  having  an  aggregate  weight  of 
12  lbs.  These  were  expelled  with  much  straining  and  suffering. 
LaMaitre  and  Rodet  record  other  cases.  Stockfleth  describes 
multiple  pediculated  fibroid  tumors  in  the  womb  of  the  cow. 
Cysts  have  been  especially  seen  in  the  cow  and  bitch,  and  car- 
cinoma in  the  bitch. 

Symptoms.  These  may  for  a  length  of  time  be  overlooked,  though 
breeding  animals  usually  fail  to  conceive.  Then  a  slimy,  muco- 
purulent, serous,  bloody  or  foetid  discharge  may  escape  habitually 
from  the  vulva,  smearing  the  tail  and  hips  and  collecting  on  the 
floor.  If  the  os  is  sufficiently  patent  to  admit  the  hand  vaginal 
and  uterine  exploration  will  detect  the  tumor.  In  other  cases  it 
may  be  felt  by  rectal  examination. 

Treatment  is  essentially  surgical  and  will  consist  in  dilatation 
of  the  OS,  and  the  removal  of  the  tumor  by  twisting,  ecraseur,  or 
curette,  and  with  careful  antiseptic  precautions  before  and  after. 
In  malignant  tumors  in  the  uterine  walls  it  may  be  expedient  to 
remove  the  entire  organ. 


UTERINE  TUBERCLE. 

This  has  been  seen  especially  in  sterile  cows,  the  subjects  of 
nymphomania,  and  it  may  be  associated  with  a  muco-purulent  or 
bloody  discharge  from  the  vulva,  nodular  swelling  on  the  uterine 
horns,  perhaps  also  on  the  broad  ligaments,  one  or  both  ovaries, 
and  the  mesentery,  to  be  recognized  by  rectal  examination.  The 
presence  of  tuberculosis  in  the  lungs  or  throat,  and  the  response 
to  the  tuberculin  test  will  confirm  the  diagnosis.  As  a  rule  it  is 
not  desirable  to  institute  treatment. 


IMPERFORATE  HYMEN. 

Cases  of  this  kind  have  been  described  in  mare  and  cow,  pre- 
venting copulation  and  conception,  and  leading  to  a  distension  of 
the  vagina,  with  a  glairy  fluid,  which  obstructed  defecation, 
irritated  the  bladder  and  caused  violent  but  fruitless  straining, 
under  which  the  mass  would  project  from  the  vulva.  The  centre 
of  the  swelling  may  be  penetrated  with  a  trochar  or  bistuory  and 
enlarged  by  incisions  in  several  directions.  Relief  is  prompt  and 
lasting. 

VAGINITIS.     LEUCORRHCEA.  ' 

Inflammation  of  the  vaginal  mucosa  is  usually  a  concomitant 
of  metritis  and  like  that  follows  parturition.  It  will  however  oc- 
cur independently  from  direct  injury  or  infection  or  from  the 
presence  of  neoplasms.  In  dourine  and  horse-pox,  vaginitis  is  a 
common  symptom  ;  to  mare,  cow  and  bitch  infection  is  conveyed 
by  coition.  Dieckerhoff  quotes  old  chronic  cases,  also  acute  ones 
which  extended  to  the  peritoneum  and  proved  fatal  in  a  few 
days.  The  common  symptom  of  muco-purulent  discharge  having 
a  heavy  or  foetid  odor  is  together  with  the  discharge  from  the 
womb  known  by  the  common  name  of  leucorrhoea.  The  frequent 
irrigation  of  the  whole  passage  with  antiseptic  solutions  is  usually 
successful  in  putting  a  stop  to  the  affection,  unless  in  case  of  con- 
stitutional infection,  or  the  presence  of  some  neoplasm. 
300 


TUMORS  OF  THE  VAGINA. 

The  vagina  is  the  seat  of  different  forms  of  neoplasms  in  the 
various  domestic  animals.*  Thus  cystoma,  lipoma,  adenoma, 
fibroma,  fibro- myoma,  sarcoma  and  epithelioma  have  been  noted. 
They  are  essentially  surgical  and  to  be  dealt  with  as  such.  They 
are  mainly  important  in  thfs  connection  as  inducing  a  leucorrhcea, 
which  in  the  absence  of  careful  examination  might  be  mistaken 
for  that  of  uterine  or  vaginal  infective  inflammation. 


PARTURITION    FEVER    (COLLAPSE).      MILK  FEVER. 

PARTURIENT  APOPLEXY.      CALVING  FEVER. 

PARTURITION  PARESIS. 

Definition.  Predisposing  causes  :  genus,  breed,  great  milking  capacity, 
heredity,  mature  age,  vigor,  high- feeding,  powerful  digestion  and  assimila- 
tion, sudden  plethora,  drying  up  of  milk,  parturition,  easy  delivery,  warm 
season,  chills,  idiosyncrasy,  cardiac  hypertrophy,  contraction  of  womb, 
emotional  excitement :  Supposed  causes  :  absorption  of  toxins  from  womb, 
colostrum,  Schmidt  treatment  its  significance,  microbian  infection  and  in- 
toxication, effect  of  change  of  stable.  Microbiology.  Nature  :  Theories  of 
nervous  explosion,  vaso-motor  cerebral  anaemia  from  exaggerated  excita- 
bility of  the  uterine  nerves,  or  from  dilatation  of  the  portal  system  and 
womb,  metro  peritonitis,  cerebral  anaemia  from  congestion  of  the  rete 
mirabile,  etc.,  palsy  of  the  ganglionic  nerves,  plethora,  intra  cranial  arterial 
tension,  narcotic  poisons  from  leucocytic  or  microbian  source.  Lesions : 
variable,  cerebral  and  spinal  congestion,  pulmonary  congestion,  collapse, 
septic  inhalation,  bronchitis,  dessication  of  ingesta  in  omasum  and  large 
intestine,  black  thick  blood,  yellowish  gelatiiioid  exudates  in  cranium  and 
spinal  canal  and  under  spine,  glycosuria.  Symptoms  :  time,  post  partur- 
ient, plethoric  subject,  sudden  onset,  comatose  and  violent  forms,  discom- 
fort, restless  movements,  inappetence,  moaning,  mental  dullness,  unsteady 
walk,  muscular  weakness,  compulsory  recumbency,  retained  urine  and 
faeces,  drowsiness,  somnolence,  unconsciousness,  stertor,  venous  pulse, 
tympany,  sudden  recovery,  complete,  with  paralysis,  fatal  cases,  violence, 
tossing  head,  trembling,  cramps,  convulsions,  temperature.  Mortality. 
Prevention  :  bleeding  in  plethoric,  heavy  milkers,  purging,  low  diet,  exer- 
cise, comfort,  milking,  blisters,  sucking  by  calf,  disinfection,  iodine  solution 
301 


302  Veterinary  Medicine. 

in  udder.  Treatment :  in  early  stages  bleeding,  purgatives,  peristalsis 
stimulants,  antiseptics,  injections,  stimulants,  rubefacients  or  cold  sponging, 
elevation  of  the  head,  udder  massage,  milking,  iodine  injection  of  the 
mammae  with  iodine  or  creolin  or  salt  solution,  oxygen  or  sterile  air. 

Definition.  A  nervous  disorder  which  develops  suddenly  in 
plethoric  cows,  heavy  milkers,  after  calving,  and  is  characterized 
by  loss  of  sense,  of  consciousness  and  of  muscular  control,  by 
hypothermia  or  hyperthermia,  convulsions,  coma,  and  mellituria. 

Causes.  While  one  cannot  speak  positively  as  to  the  essential 
cause  of  this  disease,  certain  conditions  are  so  constant  and 
prominent  that  they  must  be  given  a  high  value  ?iS  pre- disposing 
causes. 

Genus  and  Breed.  Milking  Capacity.  This  is  essentially  a 
disease  of  cows,  probably  largely  because  of  all  domestic  animals, 
cows  only  have  been  long  and  systematically  bred  to  secure  the 
greatest  power  of  digestion  and  assimilation  and  the  highest  yield 
of  milk.  It  is  the  disease  not*  only  of  cows,  but  of  milking 
breeds,  and  preeminently  of  individuals  that  give  the  most  abun- 
dant dairy  product.  It  is  rare  or  unknown  in  scrub  or  common 
herds,  while  common  and  fatal  in  the  best  milking  breeds,  in  ad- 
vancing ratio  about  as  follows  :  short  horn,  red  polled,  Normand, 
Swiss,  Ayrshire,  Flemish,  Dutch,  Aldemey,  Jersey,  Guernsey, 
and  Holstein.  Heredity  may  be  claimed,  as  the  special  pre-dis- 
posing  qualities  are  hereditary. 

Age  has  a  marked  influence,  but  this  is  subsidiary  to  the  milk- 
ing qualities.  The  disease  rarely  attacks  a  cow  after  the  first  or 
second  calving  when  the  system  is  as  yet  immature,  and  the  milk 
yield  has  not  reached  its  maximum  :  nor  one  that  is  past  its 
prime  and  already  failing  in  vital  energy  and  milking  qualities. 
The  following  table  is  from  statistics  complied  from  veterinary 
records  in  Denmark  and  Bavaria  : 


Age.yrs— 3 

456789 

10 

II 

12 

13  and  over. 

Cases         8 

21     65    160    171    202   117 

124 

44 

70 

78 

It  will  be  noted  that  it  is  in  the  period  of  the  most  vigorous, 
mature  life,  from  the  6th  to  the  loth  year  inclusive  that  the  great 
majority  suffer.  In  a  judiciously  managed  dairy  it  is  the  best 
cows  that  are  carried  at  these  ages,  and  although  the  very  best 
are  kept  on  into  old  age  they  show  a  steadily  decreasing  number 
of  cases  as  they  begin  to  fail.  The  disease  is  all  but  unknown 
in  primipara. 


Parturition  Fever,  Etc,  303 

High  Feeding.  Heavy  and  rich  feeding  prior  to  calving  and 
immediately  after,  is  a  most  prominent  cause  of  the  affection. 
This  is  so  well  known  to  owners  of  milking  breeds,  that  they 
usually  hold  to  the  principle  that  the  cow  that  is  a  heavy  milker, 
should  be  all  but  starved  for  a  fortnight  before  calving  and  for  a 
week  after.  In  herds  where  this  rule  is  acted  on  the  disease  is 
rare  and  may  be  altogether  unknown,  and  when  it  is  neglected  the 
malady  is  often  very  destructive. 

Plethora,  High  Condition.  Heavy  feeding  and  high  condi- 
tion usually  go  together,  and  the  majority  of  the  victims  are  fat  or 
in  good  flesh,  yet  a  certain  number  are  actually  thin.  The 
predisposing  condition  is  plethora  rather  than  fat  or  flesh,  and 
this  may  be  present  in  the  comparative  absence  of  flesh.  The 
cow  that  is  from  a  stock  famed  as  heavy  milkers,  does  not  tend  to 
lay  on  flesh,  but,  on  succulent  diet  especially,  the  greater  part  of 
the  nutritive  matter  assimilated  goes  to  the  production  of  milk, 
and  she  remains  thin  in  flesh  no  matter  how  heavily  she  may  be 
fed.  Many  such  cows  never  go  dry,  but  give  a  liberal  yield  of 
milk  up  to  the  day  of  calving,  and  if  measures  are  taken  to  dry 
them  up,  it  is  done  at  the  expense  of  a  sudden  plethora,  as  the 
milk  giving  system  does  not  at  once  accommodate  itself  to  the 
la>nng  up  of  fat  and  flesh. 

The  drying  up  of  the  milk  secretion  sometime  before  calving  in 
a  cow  which  is  normally  a  heavy  milker  is  therefore  a  potent  factor. 

Parturition  is  an  almost  indispensable  factor  as  the  disease  oc- 
curs one  to  seven  days  after  that  act,  and  only  in  rare  and  some- 
what doubtful  cases  before  it. 

Easy  Delivery  with  little  nervous  outlay  or  loss  of  blood,  and 
no  exhaustion  is  a  special  feature.  The  attack  almost  nevfer  oc- 
curs after  a  difficult  parturition  with  considerable  loss  of  blood 
and  much  nervous  exhaustion.  This  should  to  a  large  extent 
exclude  such  alleged  factors  as  shock  or  wearing  out  of  nervous 
energy.  The  nervous  prostration  which  figures  so  prominently 
in  the  disease,  seems  to  be  less  the  result  of  wear  and  tear,  than 
of  the  supply  of  an  excess  of  blood,  which  is  either  over- 
enriched,  or  charged  with  some  injurious  toxic  matter.  At  the 
same  time  there  is  a  manifest  susceptibility  at  the  parturient 
period  which  is  not  present  at  other  times,  and  the  plethora  or 
toxin  takes  occasion  to  operate  when  this  predisposition  renders 


304  Veterinary  Medicine, 

such  an  attack  possible.  The  Warm  Summer  Season  has  been 
claimed  to  induce  a  greater  number  of  cases,  and  doubtless  ex- 
posure to  continuous  heat,  tends  to  prostrate  the  nervous  system 
and  predispose  to  congestion,  this  fails  to  take  into  account  the 
still  more  important  element  of  the  rich  spring  and  early  sum- 
mer pastures;  where  the  already  plethoric  animal  is  left  to  feed 
without  stint,  or  the  tempting  red  clover,  alfalfa  and  other  fodder 
crops,  rich  in  albuminoids,  which  are  fed  liberally  in  a  succulent 
condition. 

Chills  in  cold  winter  weather  have  been  similarly  invoked  as 
driving  the  blood  from  the  surface  to  collect  in  internal  organs, 
including  the  brain.  That  chills  do  act  in  this  way  cannot  be 
denied,  but  there  is  no  demonstration  that  any  number  of  cases 
have  been  materially  affected  by  cold. 

Idiosyncrasy,  Co^istitutional  Predisposition,  This  must  be  al- 
lowed, inasmuch  as  that  it  covers  all  those  individual  conditions, 
functional  and  structural,  which  belong  to  the  heavy  milker,  or 
the  animal  with  extraordinary  powers  of  digestion  and  assimila- 
tion. The  same  shows  in  the  predisposition  to  a  second  attack 
of  an  animal  which  has  survived  a  first  one.  The  structural 
changes  in  the  nerve  centres,  which  occur  in  the  primary  attack, 
leave  traces,  which  render  these  parts  more  susceptible  at  the 
next  calving.  In  my  own  experience  the  violence  of  the  disease 
is  liable  to  increase  with  successive  attacks,  so  that  a  second  or 
third  cannot  be  hoped  to  be  as  mild  as  was  the  former  one. 

Cardiac  Hypertrophy,  Cagny  draws  attention  to  the  fact  that 
in  man  and  beast  alike  the  heart  undergoes  hypertrophy  during 
gestation  and,  above  all,  during  the  later  stages.  In  improved 
breeds  of  cattle,  and  especially  in  milking  breeds,  a  great  de- 
velopment of  the  whole  circulatory  system  is  seen,  and  a  large 
heart  is  a  constant  feature  of  this.  This  implies  an  increased 
force  of  cardiac  systole,  an  increased  blood  tension  in  the  arteries 
and  capillaries,  a  condition  which  tells  with  special  force  on  the 
soft  tissues  of  the  brain,  as  the  violent  abdominal  compression  in 
the  expulsive  efforts  of  parturition,  tends  to  drive  the  blood  from 
the  great  vascular  viscera  situated  back  of  the  diaphragm. 

Parturition  and  the  subsequent  contraction  of  the  womb  and  ex- 
pulsion of  the  great  mass  of  blood,  must  be  accorded  a  prominent 
place  among  causative  factors.     The  disease  is  almost  restricted 


Parturition  Fever ^  Etc,    ,  305 

to  the  first  week  after  parturition,  and  its  gravity  is  greater  the 
more  nearly  it  is  related  to  the  parturient  act.  Cases  occurring  in 
the  first  three  days  are  usually  fatal.  The  gravid  uterus  contains 
a  very  large  amount  of  circulating  blood,  and  when  the  womb  con- 
tracts, the  greater  part  of  this  is  suddenly  thrown  upon  the  general 
circulation,  already  plethoric  to  an  undue  extent.  As  yet  the 
mammae  are  congested  and  there  is  no  free  depletion  through 
that  channel,  so  that  there  is  a  marked  temporary  plethora  and 
vascular  tension,  before  the  system  can  establish  free  elimination 
and,  as  it  were,  strike  a  healthy  balance.  In  this  period  of  tran- 
sient plethora  there  lies  a  source  of  great  danger  to  the  general 
system  and,  more  particularly,  to  the  brain. 

Emotional  Excitement  connected  with  the  removal  of  the  calf 
is  urged  by  Giinther,  Jaumain,  F61izet  and  others  as  a  prominent 
cause.  This,  however,  must  be  rare,  at  the  most ;  the  disease 
does  not  attack  the  primipara  that  should  be  most  susceptible  to 
this  influence,  but  the  mature  animal,  at  her  third  calving  or 
later  when  she  is  already  well  accustomed  to  this  treatment ;  it 
supervenes  so  quickly  on  parturition  in  many  cases,  that  there 
was  no  opportunity  for  such  emotion  ;  it  occurs  also  in  cows,  the 
calves  of  which  have  remained  with  them  or  have  received  no  at- 
tention from  them. 

Absorption  of  Leucornaines  from  the  Udder.  At  parturition  the 
trophic  and  secretory  activity  of  the  udder  of  the  heavy  milking, 
plethoric  cow  is  phenomenal,  and  with  this  extraordinary  and 
sudden  rise  in  the  circulation,  and  in  cell  growth  and  work  there 
is  a  corresponding  increase  in  the  leucomaiiies  or  toxic  alkaloids 
of  the  cells.  If  those  alkaloids  are  promptly  introduced  in  large 
quantity  into  the  general  circulation,  the  highly  susceptible 
nerve  centres  at  once  succumb  to  the  poison.  This  theory  agrees 
perfectly  with  the  therapeutic  developments  of  the  last  few  years. 
The  Schmidt  treatment,  by  injecting  the  teats  with  a  quart  of 
water  holding  100  to  200  grains  of  iodide  of  potassium  in  solution, 
reduced  the  mortality  from  the  disease  from  70  per  cent  to  15  per 
cent.  Injections  of  other  antiseptic  solutions  proved  equally  effec- 
tive. So  did  a  simple  normal  salt  solution.  Overfilling  of  the 
udder  with  milk  by  putting  off  the  first  milking  for  24  hours 
after  calving  virtually  put  a  stop  to  cases  of  the  disease.  The 
filling  of  each  teat  and  quarter  of  the  udder  to  repletion  with 
20 


3o6  Veterinary  Medicine, 

oxygen  in  every  case  of  milk  fever,  reduced  the  mortality  to  a 
fraction  of  one  per  cent.  Finally  the  injection  with  simple 
sterilized  air  proved  equally  effective  and  deaths  came  to  be  con- 
sidered as  extremely  improbable  even  in  very  bad  cases.  This 
points  unequivocally  to  the  arrest  of  the  formation  of  leucomaines 
by  the  reduction  of  the  circulation  in  the  udder.  The  extreme 
distension  of  the  milk  ducts  and  follicles  by  bland  gas,  or  liquid, 
compresses  the  vessels  in  their  walls  and  reduces  the  flow  of 
blood.  With  this  reduction  of  the  circulation  comes  the  arrest  of 
the  formation  of  the  toxic  leucomaines  and  of  their  absorption. 
When  the  poison  no  longer  reaches  the  nerve  centres  in  danger- 
ous quantity  the  nervous  disorder,  and  collapse  are  prevented  or 
corrected.  This  hypothesis  explains  every  phenomenon  apd  is 
obviously  the  right  one. 

Microbian  Infection  or  Intoxication,  This  has  been  of  late  a 
favorite  hypothesis,  apparently  sustained  by  the  sudden  and  pro- 
found prostration  of  the  nerve  centres,  the  notorious  prevalence 
of  milk  fever  in  given  hamlets,  and  the  occasional  arrest  of  the 
disease  in  a  herd,  by  moving  the  parturient  cows  to  a  previously 
unoccupied  stable  and  holding  them  there  until  nine  days  after 
calving.  But  on  the  other  hand  the  disease  occurs  in  the  strong 
plethoric  cow,  not  in  the  impoverished  one  which  should  have 
less  vital  resistance  ;  it  follows  the  easy  unassisted  parturition  in 
which  there  has  been  no  chance  for  the  introduction  of  bacteria 
by  the  womb  nor  any  shock  nor  exhaustion  to  render  the  system 
more  susceptible,  while  it  respects  the  cases  of  diflScult  parturition 
with  abundant  introduction  of  microbes  on  hands  and  instru- 
ments ;  no  inoculation  from  the  womb  upon  another  parturient 
cow  has  produced  the  disease  ;  finally,  if  it  were  due  to  the  ab- 
sorption of  microbes  or  their  toxins  from  the  milk  in  the  udder 
the  bacteria  should  be  increased  in  the  abundant  lacteal  culture- 
medium  and  the  absorption  of  the  toxins  more  active  from  the 
tense  and  overfilled  milk  ducts  into  the  relatively  more  flaccid 
blood  vessels,  whereas  the  simple  overdistension  with  milk  is  the 
best  prevention  of  the  disease.  The  mere  presence  of  cocci  or 
bacilli,  which  are  by  no  means  constant,  nor  always  of  the 
same  species  in  cases  where  they  do  occur,  can  mean  nothing  as 
causative  factors  in  the  face  of  the  above  facts.  In  short,  bac- 
teridian  infection  of  womb  or  udder  must  be  eliminated  from  the 
list  of  essential  causes. 


Parturition  Fever,  Etc.  307 

Nature  of  Milk  Fever,  As  above  intimated,  everything  points 
to  the  excessive  production  of  leucomaines  in  the  udder  which 
has  been  called  to  undergo  a  sudden,  phenomenal  congestion  and 
physiological  activity.  The  other  explanations,  put  forth  at 
different  times,  are  one  and  all  untenable.  Contamine  considers 
the  disease  as  the  reaction  of  the  surplus  nerve  force,  which  was 
not  used  up  in  the  easy  parturition.  The  theory  is  fantastic  as 
accounting  for  the  rapidly  developing  aesthenia  and  paralysis. 
Billings  thinks  the  cerebral  anaemia  is  due  to  vaso-constriction 
produced  by  the  exaggerated  excitability  of  the  uterine  nerves. 
Yet  the  most  marked  features  of  these  cases  is  the  quiescence  of 
the  womb.  Trasbot  looks  on  the  affection  as  a  congestion  of  the 
myelon  apparently  shutting  his  eyes  to  the  far  more  prominent 
encephalic  symptoms.  Haubner  considers  it  as  a  cerebral  anaemia 
induced  by  the  vaso-dilatation  in  the  portal  system  and  abdominal 
viscera  generally,  the  result  in  its  turn  of  the  vacuity  of  the 
abdomen,  from  the  expulsion  of  the  foetus  and  its  connections. 
But  the  womb  is  often  contracted  and  comparatively  exsanguine, 
the  plethoric  condition  of  the  systemic  vessels  is  suddenly  in- 
creased by  the  great  mass  of  blood  from  the  uterine  vessels  which 
maintains  a  marked  general  blood  tension,  and  finally,  the  closed 
box  of  the  cranium  cannot  have  its  blood  drained  from  it  without 
some  effusion  to  take  its  place.  Stockfleth  attributed  the  malady 
to  a  metro-peritonitis,  but  there  is  rarely  any  indication  of  such  a 
condition.  Frank  claims  a  cerebral  anaemia  due  to  an  over-dis- 
tension of  the  rete  mirabile^  but  sheep  and  goats,  with  more 
abundant  retia  mirabilia,  do  not  suffer.  Palsy  of  the  ganglionic 
system  with  succeeding  congestion  of  the  myelon  and  encephalon 
(Barlow,  Kohne,  Carsten  Harms)  fails  to  explain  why  the  effects 
are  concentrated  on  the  cephalic  nerve  centres.  Glucosuria  is 
constant  in  the  disease  in  ratio  with  its  violence,  but  this  contin- 
ues for  days  after  the  cow  has  recovered  and  is  to  be  looked  on 
as  a  result  of  disorder  of  the  medulla  and  consequent  derange- 
ment of  the  liver  and  not  as  the  cause. 

Lesions,  These  are  exceedingly  variable  in  successive  cases. 
Congestion  and  effusion  in  the  meninges,  cerebral  or  spinal,  in 
the  rete  mirabile  and  choroid  plexus  have  been  often  noticed,  and 
exceptionally  clots  of  extravasated  blood.  In  certain  cases  con- 
gestion and  pink  discoloration  of  portions  of  the  brain  substance 
(cerebral  convolutions,  bulb,  ganglia)  with  marked  puncta  vas- 


3o8  Veterinary  Medicine, 

culosa,  are  found,  while  in  others  the  greater  part  or  the  whole 
of  the  encephalon  is  anaemic.  The  puncta  in  such  cases,  large 
and  dark,  on  the  surface  of  the  section,  promptly  enlarge  until 
they  may  form  distinct  drops. 

In  the  lungs  areas  of  collapse,  and  of  dark  red  congestion  and 
infiltration  are  common,  mostly  as  the  result  of  the  entrance 
of  alimentary  or  medicinal  matters  into  the  bronchia  owing  to 
palsy  of  the  pharynx.  Such  materials  can  be  found  in  the 
bronchial  tubes. 

The  third  stomach  and  the  large  intestine  may  be  impacted, 
the  contents  more  or  less  baked  and  glossy  on  the  surface,  and 
coincident  congestions  of  the  mucosa  are  not  uncommon.  In 
some  instances,  however,  the  contents  are  soft  and  pultaceous 
and  the  absence  of  mucous  congestions  is  remarkable. 

The  womb  rarely  shows  characters  diflFering  from  the  condition 
which  is  normal  to  the  first  few  days  after  parturition. 

The  blackness  and  thickness  of  the  blood  has  been  noted  by  prac- 
tically all  observers.  This  is  partly  the  result  of  its  density,  but 
doubtless  also  of  the  undetermined  toxins  which  are  operative 
in  the  disease. 

Yellowish  gelatinoid  exudates  have  been  found  in  the  subdorsal 
and  sublumbar  regions,  as  well  as  the  cranium  and  spinal  canal. 

Glucose  appears  to  be  constantly  present  in  the  urine,  and  in 
excess  in  the  more  violent  and  fatal  cases :  from  1.19  grm.  per 
litre  in  slight  cases  to  41.8  grms.  in  a  fatal  one  (Nocard).  Al- 
bumen may  be  present,  though  probably  only  when  local  inflam- 
mation has  supervened. 

Symptoms,  The  conditions  of  the  attack  should  be  noted. 
This  is  a  disease  of  the  first  six  days  after  parturition,  rarely 
seen  in  the  second  week,  and  never  after  the  fourteenth  day.  It  is 
very  exceptional  before  parturition,  yet  Miiller  quotes  47  cases  in 
1 107  births.  The  breed,  condition,  milking  qualities,  plethora, 
feeding,  etc.,  of  the  patient  are,  as  already  noted  important  data 
in  diagnosis.     The  onset  is  sudden  without  premonitory  symptoms. 

Two  very  distinct  types  are  met  with,  the  comatose  and  vio- 
lent or  spasmodic,  which,  however,  merge  into  each  other  by 
insensible  gradations,  and  may  follow  each  other. 

From  twelve  to  seventy  hours  after  an  easy  parturition  there 
suddenly  appear  signs  of  discomfort.    Feeding  and  rumination 


Parturition  Fever^  Etc,  309 

cease,  the  calf  is  neglected,  there  may  be  plaintive  moaning,  the 
eyes  seem  dull  and  clouded,  the  eyelids  drooped,  the  conjunctiva 
red,  the  pulse  normal  for  parturition,  sometimes  extra  strong,  the 
breathing  excited  often  with  moans  or  grunts.  The  senses  are 
dulled,  the  walk  is  unsteady,  the  feet  being  abducted  and  planted 
like  clumps,  or  the  legs  sway,  perhaps  cross  each  other,  remain 
semi-bent,  and  soon  give  way  leaving  the  animal  prostrate,  rest- 
ing on  the  sternum  and  abdomen,  or  later  on  the  ribs,  with  head 
extended.  Attempts  may  still  be  made  to  rise,  but  this  is  rarely 
accomplished  unless  when  improvement  sets  in.  This  is  the  con- 
dition in  which  the  patient  is  usually  found,  being  the  first  to 
be  noticed  by  the  owner.  The  bowels  are  torpid,  the  urine 
retained  in  the  bladder,  and  the  animal  may  remain  thus  in  a 
drowsy  condition,  without  changing  from  the  stemo-ventral  de- 
cubitus, or  dropping  the  head  on  the  ground  until  improve- 
ment sets  in.  The  head  rests  on  the  shoulder  or  upper  flank. 
If  held  outward  or  forward  the  upper  border  of  the  neck  has 
an  S  shaped  outline. 

More  commonly  the  somnolence  increases,  passing  into  a 
complete  torpor,  insensibility,  the  eye  may  be  touched 
without  causing  winking,  pricking  or  other  injury  causes  no 
further  Tesponse,  the  patient  turns  upon  its  side,  with  its  head 
extended  on  the  ground.  She  may  lie. in  this  condition  with 
no  sign  of  vital  activity  save  pulsation  and  breathing,  and  the 
latter  is  liable  to  be  slow  and  stertorous  bj'  reason  of  the  paraly- 
sis of  soft  palate  and  larynx.  The  jugulars  usually  show  a 
venous  pulse.  Fermentations  in  the  inactive  paunch  cause  the 
evolution  of  gas  with  tympany,  which  still  further  obstructs  the 
breathing,  and  reacts  injuriously  on  the  nerve  centres.  The 
normal  eructations  from  the  rumen  may  continue,  with  liquids 
and  floating  solids,  and  in  the  paralytic  state  of  the  throat  these 
too  often  pass  in  part  into  the  bronchia,  causing  septic  bronchitis 
and  pneumonia.  The  same  is  liable  to  follow  the  administration 
of  liquids,  the  irritant  drugs  passing  into  the  larynx,  trachea  and 
lungs.  The  pulse  becomes  soft,  small  and  finally  almost  imper- 
ceptible.    It  may  be  50,  60  and  upward. 

In  favorable  cases,  defecation  may  still  occur,  or  the  rectum 
once  emptied  may  fill  again  through  the  continuance  of  peri- 
stalsis, the  milk  continues  to  be  secreted,  and  in  one  to  four  days, 


3IO  Veterinary  Medicine, 

spontaneous  defecation  and  micturition  may  be  resumed,  and  the 
patient  may  get  on  its  limbs  and  commence  feeding.  There  is 
usually  at  first  a  little  weakness  of  the  limbs,  but  this  is  transient 
and  health  is  restored  in  a  very  short  time.  The  suddenness  of 
the  improvement  is  often  as  marked  as  of  the  attack.  The 
patient  is  left  prostrate  and  insensible,  without  giving  any  re- 
sponse when  the  eyeball  is  touched  and  in  two  or  three  hours  it 
is  found  on  its  feet,  eating,  with  eyes  bright  and  clear. 

Some  patients,  however,  are  restored  to  ordinary  sensation,  in- 
telligence and  appetite,  while  the  hind  limbs  remain  paralytic,  or 
paretic,  and  the  station  and  gait  both  weak  and  uncertain  for 
days  or  even  weeks.  In  such  cases  there  have  been  presumably 
structural  changes  in  the  nerve  centres,  which  require  time  for 
repair. 

In  fatal  cases,  death  may  occur  quietly  from  apoplexy,  cerebral 
compression,  or  narcotism,  or  it  may  be  preceded  by  a  period  of 
marked  excitement  or  disorderly  muscular  movements.  Lifting 
of  the  head,  throwing  it  alternately  on  the  shoulder  and  on  the 
ground,  trembling  of  head,  members  and  body,  cramps  or  jerk- 
ing of  the  limbs  or  of  other  parts,  drawing  the  hind  limbs  up 
against  the  abdomen,  and  again  extending  them,  rolling  of  the 
eyes,  loud,  noisy,  irregular,  embarrassed  breathing  andi  a  run- 
ning down  pulse  are  often  marked  features. 

The  temperature  range  is  peculiar.  At  the  start  there  may  be 
some  hyperthermia  103°  or  104**  ;  with  the  advance  of  the  dis- 
ease it  tends  to  become  lower,  98°,  96°,  or  94°.  When  improve- 
ment sets  in,  it  rises  again  promptly  to  the  normal. 

Cadeac  describes  a  special  form  which  is  ushered  in  by  great 
restlessness,  bellowing,  throwing  the  head  to  right  and  left, 
grinding  the  teeth,  sucking  the  tongue,  salivation,  licking  of  cer- 
tain parts  of  the  body,  spasms  in  the  neck,  back  or  limbs,  and 
prompt  recovery,  or  lapse  into  the  comatose  condition  as  above 
described.  It  proved  less  fatal  than  the  ordinary  comatose  type, 
but  seems  to  depend  on  similar  conditions. 

Prognosis,  Mortality,  The  disease  is  very  deadly,  the  mor- 
tality in  time  past  having  reached  40,  50  or  even  60  per  cent., 
the  gravity  increasing  as  the  disease  set  in  nearer  to  parturition. 
Cases  occurring  on  the  first  or  second  day  were  mostly  fatal, 
those  at  the  end  of  the  first  week  were  hopeful,  and  those  occur- 


Parturition  Fever ^  etc,  311 

ring  during  the  second  week  were  very  hopeful.  With  the 
Schmidt  (iodine)  treatment  the  mortality  is  claimed  to  be  reduced 
to  16  or  17  per  cent.,  and  with  the  air  inflation  treatment  to  .5  per 
cent. 

Prevention,  Measures  directed  toward  the  lessening  of 
plethora  tend  to  remove  one  of  the  most  fruitful  causes  of  the 
disease  and  though  not  invariably  successful,  are  yet  of  great 
value.  The  most  direct  is  the  ahstrcLction  of  blood  in  the  last  fort- 
night of  pregnancy,  to  the  extent  of  6  or  8  quarts.  This  tends 
to  secure  a  lessening  of  the  blood  tension,  and  blood  density,  but 
there  is  the  drawback  of  a  created  tendency  to  a  subsequent  in- 
crease in  the  blood  formation  to  make  up  the  loss.  This  measure 
should  be  reserved  for  cows  that  are  very  plethoric,  extra  heavy 
milkers  and  such  as  have  already  suffered  from  the  disease. 

Purgatives  will  measurably  secure  the  same  end  without  the 
same  degree  of  danger.  One  to  two  pounds  of  Epsom  or  Glauber 
salts  in  the  last  week  of  gestation,  or  at  latest  when  labor  pains 
set  in,  tend  not  only  to  remove  solid  or  impacted  masses  from  the 
first  and  third  stomachs,  and  inspissated  contents  from  the  large 
intestines,  but  to  secure  a  free  depletion  from  the  portal  system. 
If  not  before,  this  should  always  be  given  immediately  after 
parturition  to  cows  in  extra  high  condition,  heavy  milkers,  and 
that  have  had  a  short  and  easy  delivery. 

Restriction  ofjood  for  a  week  before  and  as  long  after  parturi- 
tion is  of  equal  importance.  A  very  limited  supply  of  aqueous, 
easily  digested,  and  laxative  food  (roots,  sloppy  bran  mashes, 
fresh  grass,  ensilage)  will  meet  the  demand. 

Exercise  in  the  open  air  is  of  great  value  in  giving  tone  to  the 
muscles,  and  especially  the  nervous  system,  and  in  stimulating 
the  enunctories  and  other  functions. 

In  the  cold  season  protection  against  cold  draughts  and  chills 
must  be  seen  to,  and  in  the  hot  season  the  avoidance  of  an  excess 
of  solar  heat  and  above  all  of  the  confined  impure  air  of  the  barns. 

At  midsummer  and  later,  there  is  often  great  danger  in  the 
rich  clover  and  alfalfa  pasture,  or  soiling  crop,  with  which  the  cow 
will  dangerously  load  her  stomach,  and  the  only  safe  course  is  to 
remove  predisposed  animals  and  shut  them  up  in  a  bare  yard  or 
box-stall.  Under  such  simple  precautions  herds  that  had  formerly 
suffered  severely,  have  had  the  disease  virtually  put  a  stop  to. 


312  Veterinary  Medicine. 

In  individual  cases  other  measures  are  indicated.  When  the 
udder  has  reached  an  enormous  size  and  development,  and  is 
gorged  with  milk,  days  before  parturition,  it  may  be  syste- 
matically milked.  The  irritation  in  the  gorged  gland  is  quite  as 
likely  to  induce  premature  parturition,  as  in  milking,  and,  at  the 
worst,  the  result  is  not  so  bad  as  an  attack  of  parturition  fever. 

Basing  his  advice  on  the  fact  that  parturition  fever  does  not 
follow  a  case  of  severe  dystokia,  Cagny  applies  sinapisms  on  the 
loins,  croup  and  thighs  of  a  fleshy,  plethoric,  heavy  milking, 
parturient  cow.     Proof  of  their  eflficacy  is  not  obtainable. 

Felizet  advises  leaving  the  calf  with  its  dam  for  one  week. 
Kohne  doses  the  cow  with  nux  vomica :  Harms,  with  tartar 
emetic. 

In  view  of  the  probability  of  a  bacterial  infection  the  cow 
should  be  taken  to  a  clean,  pure,  well-aired  stable  a  day  or  two 
before  calving,  having  been  first  cleansed  from  adherent  filth, 
ind  sponged  all  over  with  a  4  per  cent,  solution  of  carbolic  acid. 

To  prevent  diffusion  of  infection  Bournay  recommends  anti- 
septic injection  of  the  womb  immediately  after  calving.  Bis- 
sauge  adds  that  the  stable  should  be  disinfected  after  every  case 
of  parturition  fever,  the  manure  carefully  removed  and  the 
ground  scraped  and  well  watered  with  a  disinfectant. 

For  fleshy,  plethoric,  predisposed  cows,  the  distension  with 
air  or  gas  of  the  udder  should  be  applied  immediately  after  calv- 
ing. Or  the  udder  should  be  left  unmilked  and  gorged  with  its 
own  secretion  for  twenty-four  hours  after  calving.  These  meas- 
ures are  incomparably  more  effective  than  all  others  quoted 
above. 

Treatment,  With  the  state  of  plethora  and  congestion  abotit 
the  head  in  the  early  stages  the  question  of  bleeding  at  once  arises. 
If  early  enough  while  there  is  a  full  bounding  pulse,  and  as 
yet  no  sign  of  great  loss  of  muscular  control  it  is  often  very  bene- 
ficial, as  much  as  6  quarts  or  more  being  withdrawn.  It  is  well 
however  to  avoid  cording  the  neck,  which  must  increase  the  vas- 
cular tension  in  the  brain,  and  to  trust  rather  to  digital  com- 
pression of  the  vein.  The  blood  should  be  drawn  from  a  large 
opening  in  a  full  free  stream,  and  may  be  stopped  when  the  pulse 
softens.  In  the  more  advanced  condition,  with  paralysis  and  more 
or  less  dulling  of  the  senses,  or  coma,  bleeding  may  be  dangerous 


Parturition  Fever,  etc,  313 

rather  than  useful.  There  is  then  serious  pressure  on  the  brain, 
with  serous  effusion,  and  perhaps  blood  extravasation,  and  in  any 
case  anaemia,  and  this  latter  may  be  dangerously  or  even  fatally 
increased  by  the  lessening  of  the  blood  pressure,  without  any 
compensating  advantage  in  'the  way  of  reabsorption  of  the  effusion. 
In  such  cases  eliminating  agents  are  a  safer  resort. 

Purgatives  commend  themselves,  but  with  the  drawback  of  a 
too  tardy  action.  Now  however  with  the  peristaltic  stimulants 
given  h5rpodermically  this  objection  is  largely  obviated.  Pilocar- 
pin  lYi  gr.,  and  eserine  3  grs.  will  often  secure  a  noticeable 
movement  of  the  bowels  in  the  course  of  fifteen  minutes,  imply- 
ing a  corresponding  motion  onward  in  the  bowels  more  anteriorly^ 
and  even  of  the  contents  of  the  gastric  cavities.  If  there  is  al- 
ready palsy  of  the  muscles  of  deglutition,  this  may  be  repeated 
several  times  at  intervals  of  four  or  five  hours.  If  however  de- 
glutition is  still  well  performed  a  purgative  of  one  or  two  pounds 
Epsom  salts,  with  10  drops  croton  oil,  and  i  oz.  oil  of  turpentine 
may  be  given  by  the  mouth.  Should  this  operate,  it  will  supple- 
ment and  carry  on  even  more  effectively  the  work  of  the  hypo- 
dermic agents,  and  even  lessen  the  density,  plasticity  and  ten- 
sion of  the  blood  and  act  as  a  potent  derivative  from  the  brain. 

A  compromise  may  be  made  by  giving  aloes  2  ozs. ,  croton  oil 
20  drops  in  bolus ;  or  i  to  2  ozs.  sulphate  of  soda  in  solution 
may  be  injected  subcutem. 

In  any  case  oil  of  turpentine  or  other  antiseptic  is  of  great 
value  in.the  stomach  in  preventing  fermentation  and  tympany, 
and  thereby  obviating  a  whole  series  of  troubles  such  as  :  cerebral 
disturbance  by  nervous  shock  and  blood  pressure  ;  impaired  res- 
piration and  haematosis  by  pressure  on  the  diaphragm  :  and  eruc- 
tations of  food  to  the  pharynx  and  its  inhalation  or  gravitation 
into  the  lungs. 

It  is  always  well  to  clear  out  the  rectum  by  injections,  when  if 
there  is  any  indication  of  pharyngeal  paralysis  most  of  the 
remedies  may  be  given  by  this  channel. 

Stimulants  (ammonia  carbonate,  alcohol,  anise,  fennel,  ether, 
nux,  etc.)  have  been  largely  employed  by  the  mouth  and  may 
be  by  the  rectum.  In  the  absence  of  spasms  I  have  relied  largely 
on  nux  or  strychnia. 

When  the  skin  chills,  some  have  sought  to  heat  it  by  enveloping 


314  Veterinary  Medicine, 

the  prosterior  half  of  the  body  in  cotton  or  wool  soaked  in  tur- 
pentine, by  applying  sinapisms,  or  by  moving  over  the  surface  .a 
warming-pan  containing  red  hot  charcoal. 

More  generally  cold  in  the  shape  of  cold  water,  ice  or  snow  has 
been  applied  to  the  cranium  or  spine,  'Theoretically  the  ansemic 
brain  might  be  thought  to  forbid  this,  but  clinically  it  often  oper- 
ates well,  possibly  by  inducing  a  sympathetic  contraction  of  the 
vessels  in  and  around  the  nerve  centres  and  thus  indirectly  favor- 
ing the  resumption  of  active  circulation  and  the  reabsorption  of 
effusions. 

An  elevated  position  of  the  head  is  no  less  important.  It  favors 
the  return  of  blood  from  the  brain  by  gravitation,  and  in  this  way 
improves  the  intracranial  circulation,  and  the  resumption  of  nor- 
mal function.  A  halter,  or  a  rope  around  the  horns,  may  be  tied 
to  a  beam  overhead,  or  the  head  may  be  laid  on  thick  bundles  of 
straw  which  will  keep  it  up  to  or  above  the  level  of  the  chest,  and 
in  this  way  not  only  is  gravitation  ensured,  but  the  brain  is  pro- 
tected against  the  violent  blows  and  concussions,  which  come 
from  dashing  the  head  on  the  ground. 

Modem  Treatment  of  Milk  Fever.  The  modem  treatment  was 
inaugurated  in  1897,  when  Schmidt,  aiming  at  antisepsis,  injected 
into  the  four  teats  a  quart  of  previously  boiled  water  holding  100 
to  200  grains  of  potassium  iodide  in  solution.  The  mortality 
which  had  been  as  high  as  70  per  cent  was  at  once  reduced  to  15 
per  cent.  Others  followed  with  solutions  of  other  antiseptics 
(creolin,  cresol,  lysol,  chinosol,  boric  acid,  phenol,  and  even  com- 
mon salt)  and  had  a  corresponding  success.  The  Jersey  Island 
dair5mien  found  that  by  leaving  the  udder  unmilked  for  24  hours 
their  predisposed  cows  were  protected  against  attack.  Next  came 
the  full  repletion  of  the  udder  with  oxygen  gas  which  excelled 
all  other  methods,  reducing  the  mortality  to  a  fraction  of  i  per 
cent.  The  final  step  was  inevitable  and  the  pumping  of  the  udder 
full  of  sterilized  air  proved  the  simplest,  most  soothing  and  most 
effective  of  all.  My  first  case  in  1903  had  been  eight  hours  under 
the  Schmidt  treatment  without  relief  from  coma,  but  was  on  her 
feet  exercising  all  her  functions  healthily  2}i  hours  after  the 
sterile  air  treatment  had  been  applied.  She  lived  to  prove  the 
heaviest  milker  of  that  season  in  a  large  herd  of  extra-milking 
Holsteins.     In  one  remarkable  case  the  fever,  the  second  attack 


Parturituni  Fever,  etc,  315 

in  the  same  animal,  came  on  a  month  before  parturition,  and  a 
prompt  recovery  followed  the  distension  treatment.  Parturition 
was  accomplished  normally  and  safely  more  than  a  month  later, 
no  nervous  prostration  appearing.  In  the  past  two  years  thou- 
sands of  cases  have  been  treated  by  the  distension  method  (with 
oxj'^gen  or  sterile  air)  with  less  than  i  per  cent  of  losses. 

Technique.  To  prevent  infection,  the  main  danger,  the  most 
careful  antiseptic  or  aseptic  precautions  are  demanded. 

The  injectors  found  on  the  market  are  generally  clumsy  and 
unwieldy  but  operate  well  in  careful  hands.  In  the  absence  of 
this  an  excellent  substitute  can  be  made  from  a  common  Davidson 
syringe.  Having  secured  the  elastic  ball  and  delivery  tube 
furnished  with  valves  to  direct  the  current  of  air,  the  delivery 
tube  is  cut  across  and  the  two  ends  connected  with  a  small  glass 
tube  loosely  filled  with  sterilized  cotton.  In  the  free  end  of  the 
rubber  delivery  tube  fit  a  silver  milking  tube  for  insertion  into 
the  teat.  Sterilize  the  entire  apparatus  by  heating  in  a  water 
bath  for  five  minutes,  and  enclose  it  in  a  sterilized  towel  and  tin 
box  until  taken  out  for  immediate  use.  The  patient  is  to  be  pre- 
pared by  thorough  washing  of  udder  and  teats  with  soapsuds, 
rinsing  off  with  clean  boiled  water  at  a  moderate  temperature, 
and  finally  applying  to  the  teats  a  5  per  cent  solution  of  creolin 
or  lysol  and  supporting  the  gland  on  a  sterilized  towel  until  in- 
jected. All  being  ready  the  middle  of  the  teat  is  held  between 
the  finger  and  thumb  of  the  left  and  the  teat-tube  held  by  its 
attached  end  in  the  right  hand  is  inserted  in  the  teat,  the  elastic 
bulb  being  manipulated  by  an  assistant  until  the  quarter  is  in- 
flated like  a  bladder.  The  tube  is  now  withdraw  and  the  end  of 
the  teat  is  tied  with  a  broad  tape  to  prevent  the  escape  of  the  gas. 
The  tube  is  inserted  in  each  of  the  teats  in  turn,  with  the  same 
precautions,  and  the  other  three  quarters  are  blown  up  in  the 
same  way.  It  is  a  good  practice,  in  passing  the  tube  from  one 
teat  to  another,  to  dip  the  tube  in  strong  creoline,  rinse  it  off  in 
boiled  water  and  then  it  is  in  an  aseptic  condition.  The  cotton 
used  as  a  filter  may  have  a  small  crystal  of  some  volatile  anti- 
septic (salol,  naphthol,  thymol)  inserted  into  it.  This  is  not 
strictly  necessary,  yet  it  is  an  excellent  placebo  and  serves  to  en- 
hance the  impression  of  the  importance  of  the  other  and  more 
indispensable  antiseptic  measures.     The  recumbent  cow  should 


3i6  Veterinary  Medicine, 

be  kept  on  her  breast  bone  with  the  head  elevated  even  if  it 
should  be  necessary  to  pack  her  around  with  straw  bundles  or  to 
suspend  the  head  by  a  halter.  Lying  on  her  side  is  liable  to 
develop  bloating,  regurgitation  from  the  paunch,  and  inhalation 
bronchitis,  or  pneumonia. 

The  almost  invariable  result  of  the  treatment  is  that  in  two  to 
two  and  a  half  hours  the  cow  gets  on  her  feet,  the  bowels  move 
freely,  urine  is  discharged  copiously,  and  water  and  food  are 
taken,  indicating  a  resumption  of  the  normal  nervous  functions. 
If  in  two  hours  the  patient  is  not  on  her  feet,  nor  looking  brighter 
and  more  intelligent,  if  she  has  passed  no  manure  and  urine,  and 
if  the  injected  air  has  been  absorbed,  leaving  the  udder  less  tense, 
the  injection  of  the  bag  may  be  repeated  under  the  same 
scrupulous  antiseptic  precautions  as  at  first.  This  may  be  re- 
peated later  if  necessary.  In  all  cases,  but  especially  in  severe 
ones,  it  is  well  to  keep  close  watch  of  the  cow  for  twenty-four 
hours,  and  if  there  is  any  indication  of  a  relapse  to  repeat  the 
treatment  by  udder  distension. 

Complications  must  be  met  according  to  their  nature.  Bloat- 
ing may  require  puncture  of  the  rumen,  evacuation  of  the  gas 
and  the  introduction  of  ammonia  solution  or  other  antiseptic. 
Inhalation  of  food-materials  may  demand  antiseptic  inhalants,  or 
even  solutions,  but  is  very  liable  to  prove  fatal.  Lesions  of  the 
back  or  limbs  may  require  appropriate  treatment.  Congestions 
or  infections  of  the  udder  may  require  active  antiseptic  injections 
(2  per  cent  solution  hydrogen  peroxide,  iodoform,  creolin )  in  such 
amount  as  will  not  diminish  the  mammary  tension.  Complications 
affecting  the  womb,  bowels,  brain  or  other  organ  must  be  dealt 
with  according  to  indications. 

The  economic  value  of  the  new  treatment  is  almost  inestimable. 
In  the  past  milk  fever  has  been  the  bane  of  the  best  dairy  herds, 
and  of  the  best  cows  in  such  herds,  of  those  which,  if  preserved, 
would  have  brought  offspring  capable  of  increasing  the  general 
yield  by  50  or  100  per  cent.  Thus  by  this  disease  the  maximum 
value  was  continually  being  cut  down,  the  survivors,  the  ances- 
tors of  future  herds,  being  mainly  the  less  valuable,  the  less  pro- 
ductive and  the  less  remunerative.  When,  however,  we  can 
guarantee  the  recovery  of  even  the  most  strongly  predisposed  cow 
from  milk  fever,  we  preserve  the  phenomenal  milker  for  a  long 


-  •  Parturition  Fever,  Etc,  317 

lifetime  of  service,  we  secure  from  her  a  numerous  progeny 
which  under  judicious  management  would  be  even  better  than 
herself,  and  we  increase  the  yield  and  profit  beyond  the  dreams 
of  the  dairyman.  Suppose  our  17,000,000  of  cows  should  have 
their  yield  doubled,  the  resulting  enhanced  profit  might  at  a  very 
moderate  computation  be  set  down  at  $30,000,000  to  $40,000,000 
per  annum.  This  assumes  that  this  modem  gift  of  veterinary 
medicine  should  be  generally  availed  of  ;  should  it  fail  to  be  so,  it 
will  be  the  fault  of  the  stockowner  in  neglecting  the  boon  which 
the  veterinary  profession  has  generously  placed  in  his  hands. 


DISEASES  Ot  THE  EYE. 

DESIRABI.E   FEATURES   IN  THE  EYE. 

The  eye  in  the  physiognomy.  Broad  forehead.  Pull  eyes.  Both  eyes 
alike.  Iris  smooth,  lustrous.  Media  translucent.  Pupil  sensitive  to  light. 
Convexity  median,  uniform.  Pupil  black  in  ordinary  light.  Lids  open  and 
mobile.  Sclera  light  pink.  Tears  clear,  limpid  without  overflow.  Lids 
thin,  delicate,  margins  evenly  curved.  Whole  eye  responsive  to  moving 
objects.  Defects  :  small  eye  :  semi-closed,  thick,  sluggish  lids ;  convex 
cornea :  sunken  eye  :  projecting  eye  :  weeping  eye  :  blear  eye  :  watch  eye  : 
irresponsive  iris  :  dilated  pupil  :  unequal  eyes :  flat  cornea ;  ovoid  cornea. 

Much  of  the  expression  of  the  face  depends  upon  the  eyes,  and 
in  animals  as  in  man  it  is  difficult  to  find  compensations  for  a  for- 
bidding countenance.  Perfect,  sound,  intelligent  eyes  are  always 
pleasing ;  imperfect,  defective,  sunken  or  lifeless  eyes  mar  the 
whole  expression.     The  following  points  may  be  specially  noted  : 

ist.  Ample  breadth  between  the  orbits.  This  is  of  great 
importance  in  the  horse,  in  which  we  seek  for  intelligence, 
courage  and  indomitable  energy.  This  conformation  does  not  in- 
dicate the  size  of  brain,  as  the  cranium  is  situated  higher  up,  but 
by  placing  the  eyes  well  outward,  it  indicates  a  wider  range  of 
vision,  and  usually  implies  large,  clear  eyes,  and  since  interde- 
pendent parts  tend  to  correspond  in  development  and  quality, 
this  commanding  vision  bespeaks  a  large,  active  brain,  intelli- 
gence, docility  and  activity. 

2d.  Full,  prominent  eyes.  This  may  be  excessive,  eitheJ 
through  primary  conformation  or  disease.  Abnormal  convexity 
of  the  cornea  implies  myopia.  But  within  normal  limits  the 
prominent  eye  suggests  good  health,  condition  and  vigor,  with 
ample  cushions  of  fat  under  the  bulb  and  a  sound,  well-developed 
condition  of  the  eyeball  and  its  muscles, 

3d.  Both  eyes  equal  in  all  respects.  Any  variation  in 
size,  shape,  color,  fullness,  clearness  or  in  any  other  respect  is  at 

318 


Diseases  of  the  Eye.  319 

best  unsightly,  and  implies  not  only  defect  but  often  disease  as 
well. 

4th.  The  iris  should  be  lustrous,  uniform  in  color  and 
even  in  surface.  Whether  dark  brown  as  in  the  horse,  or  yel- 
low as  in  the  dog,  it  should  be  brilliant.  Any  part  that  lacks 
lustre,  being  lighter  brown,  or  yellow  and  dull  like  a  dead  leaf, 
usually  indicates  previous  disease  and  a  tendency  to  further 
trouble.  Albinos  and  those  in  which  the  pigment  is  congenitally 
absent  in  patches  must  be  considered  as  exceptions,  yet,  even  in 
them,  the  peculiarity  cannot  be  held  to  add  to  the  beauty. 

5th.  All  the  Media  (Cornea,  aqueous  humor,  lens  and  vit- 
reous) must  be  perfectly  clear  and  translucent.  The  slightest 
cloudiness  or  opacity  in  any  of  these  is  a  serious  blemish  and 
usually  indicates  disease,  past  or  present. 

6th.  The  pupil  should  promptly  and  freely  respond  to 
light  and  darkness  by  contraction  and  expansion.  Absence  or 
tardiness  of  movement  indicates  impaired  vision,  from  disease  of 
the  eye,  its  nerves,  or  their  nerve  centres. 

7th.  Each  cornea  should  have  a  median  convexity,  uni- 
form in  all  directions  implying  the  absence  of  myopia, 
presbyopia  and  astgimatism.  Any  deviation  from  this  will 
interfere  with  the  perfection  of  sight,  and  endanger  shying  and 
other  troubles. 

8th.  Under  ordinary  light  the  pupil  should  appear  black 
throughout.  In  the  larger  animals  such  dilation  of  the  pupil  as 
to  expose  the  tapetum  lucidum  under  such  circumstances  implies 
impaired  vision  (amblyopia,  amaurosis),  inflammation  of  the 
iris  or  undue  intraocular  pressure.  A  white  color  or  spot  shows 
cataract. 

9th.  The  lids  must  be  open  and  mobile  without  excessive 
dilation.  Tardily  moving  or  semi-closed  lids,  distorted  by  scar 
or  angle,  everted  or  inverted,  are  unattractive  and  usually  imply 
disease  in  the  eye,  nerves  or  brain. 

loth.  The  unpigmented  portion  of  the  sclera  should  be 
light  pink.  The  dark  red  of  congestion  and  the  pallor  of  anaemia 
are  equally  objectionable. 

nth.  The  tears  must  be  clear,  limpid  and  confined  within 
the  lower  lid.  Any  milkiness,  flocculency  or  overflow  is  in- 
dicative of  disease. 


320  Veterinary  Medicine, 

1 2th.  The  eyelids  must  be  thin,  delicate,  evenly  and 
uniformly  curved  along  the  borders,  and  fringed  by  an 
abundance  of  strong,  prominent  and  well  directed  lashes. 
Puffiness  or  swelling  betrays  inflammation,  dropsy,  anaemia, 
parasitism  or  other  disorder,  angularity  of  the  upper  lid  an  in- 
ternal ophthalmia,  and  depilation  or  wrong  direction  of  the  lashes, 
local  disease. 

13th.  The  eye  should  respond  instantly,  by  movement,  to 
new  objects  and  noises,  without  showing  undue  irritability 
or  restlessness.  The  intelligent  apprehension  of  the  objects 
will  introduce  an  aspect  of  calmness  and  docility. 


DEFECTS,  BLEMISHES  AND  ABNORMALITIES  OF  THE 
HORSE'S  EYE. 

Some  of  these  may  be  present  in  the  absence  of  actual  disease, 
and  yet  prove  so  objectionable  that  they  disqualify  the  animal  for 
any  use,  in  which  style  or  aesthetic  appearance  is  demanded. 
Among  such  sources  of  disqualification  may  be  noted  : 

ist.  The  small  eye.  One  or  both  eyes  may  appear  small 
because  of  internal  pain  and  retraction  within  their  sockets,  or 
from  actual  atrophy  or  contraction  of  the  eyeball,  the  result  of  deep 
seated  disease,  or  the  organ  may  be  congenitally  small,  and  deep 
seated  in  the  orbit,  and  the  thick,  tardy  eyelids  may  have  a  narrow 
opening  through  which  they  can  only  be  partially  seen.  This 
last  condition  usually  implies  a  dull  lymphatic  constitution,  low 
breeding  and  a  lack  of  intelligence,  docility  and  vigor. 

2d.  The  semi-closed  eye  with  thick,  coarse,  sluggish  lids. 
In  this  case  the  bulb  may  not  be  unduly  small,  yet  as  it  is  not 
freely  exposed  it  conveys  the  same  general  expression  to  the  ob- 
server. Like  the  small  eye  it  indicates  low  breeding,  lack  of  in- 
telligence or  docility  and  often  stubbornness  or  even  vice. 

3d.  The  convex  eye.  In  this  the  transparent  cornea  de- 
scribes the  arc  of  an  unduly  small  circle,  suggesting  a  conical  form 
and  projecting  unduly  beyond  the  margins  of  the  lids.  It  implies 
imperfect  vision,  myopia,  and,  it  is  alleged,  low  breeding  and  lack, 
of  alertness. 


Defects,  Blemishes  and  Abnormalities  of  the  Horse's  Eye,      321 

4th.  The  sunken  eye.  This  has  been  already  referred  to 
under  the  small  eye.  The  eyelids  are  usually  flaccid,  the  upper 
being  drawn  in  by  its  levator  so  as  to  form  an  angle,  and  the 
edges  of  the  orbit  are  somewhat  prominent.  It  is  seen  in  old, 
worn  out  animals,  which  have  lost  the  pads  of  fat  in  the  depth 
of  the  orbit,  and  more  commonly  in  animals  that  have  suffered 
several  attacks  of  recurrent  opthalmia. 

5th.  The  projecting  eye.  In  this  case  the  lids  are  unduly 
contracted  and  the  eye  protrudes  between  them  so  as  to  show  a 
large  amount  of  sclerotic  around  the  transparent  cornea.  This 
may  be  due  to  nervous  strain  and  suffering  but,*  however  pro- 
duced it  is  decidedly  unsightly  and  objectionable. 

6th.  The  weeping  eye.  This  is  always  a  condition  of  disease. 
It  may  be  due  to  irritant  gases,  or  solid  particles,  to  inturned 
cilia,  everted  lids,  conjunctivitis  or  a  variety  of  other  conditions. 
A  careful  examination  may  show  whether  it  is  only  a  transient 
and  remediable  fault  of  a  good  eye  or  a  permanent  and  irremedi- 
able defect. 

7th.  The  blear  eye.  With  swelling  and  scabbing  of  the  edges 
of  the  lids  and  Meibonian  glands,  and  congestion  of  the  adjacent 
conjunctiva,  there  is  usually  some  blurring  of  the  surface  of  the 
transparent  cornea.  The  trouble  is  mostly  chronic  and  consti- 
tutes a  serious  objection. 

8th.  The  watch  eye.  In  this,  as  in  the  albino,  there  is  a 
lack  of  pigment,  so  that  the  iris  and  sclerotic  are  white  or  bluish 
white  in  part  or  in  whole.  »Such  an  eye  may  be  good  and  dura- 
ble, but  not  beautiful  nor  attractive. 

9th.  Blindness  of  one  or  both  eyes.  In  all  such  cases  the 
pupil  remains  fixed  and  immovable,  showing  no  accommodation 
to  light  and  darkness,  and  there  is  a  lack  of  prompt  respon- 
siveness on  the  part  of  the  eye  to  sounds  and  objects.  In  amau- 
rosis, glaucoma  and  cataract  especially,  the  pupil  remains  widely 
open,  and  alert  movements  of  the  ears  are  employed  to  make  up 
for  the  lack  of  sight.  The  condition  often  comes  from  internal 
ophthalmia,  such  as  the  recurrent  form,  and  is  associated  with 
atrophy  of  the  bulb. 

loth.  Eyes  of  unequal  size.     This  usually  implies  serious 
disease  in  one,  not  infrequently  recurring  ophthalmia. 
21 


322  Vetertfiary  Medicine. 

nth.  Too  flat  corneal  surface.  In  this  case  there  is  a  mani- 
fest lack  of  the  normal  projection,  the  anterior  surface  of  the 
cornea  describing  the  arc  of  a  larger  circle,  the  visual  rays  coming 
from  a  distance  alone  converge  on  the  retina  and  presbyopia 
occurs.  In  this  as  in  myopia  and  other  visual  imperfections  a 
horse  is  liable  to  stumble  and,  if  nervous,  to  shy. 

1 2th.  Ovoid  cornea.  In  such  cases  the  front  of  the  trans- 
parent cornea  has  an  ovoid  outline  the  arc  formed  by  it  in  one 
direction  being  that  of  a  greater  circle,  than  the  arc  which  crosses 
this  at  right  angles.  In  consequence  of  this,  the  rays  impinging 
on  the  outer  portions  of  these  respective  arcs  do  not  converge  to 
the  same  point  on  the  retina  and  a  blurred  and  imperfect  image 
results.  This  astigmatism  causes  the  subject  to  stumble  and,  if 
nervous,  to  shy. 


SYSTEMATIC  INSPECTION  OF  THE  EYE. 

System  in  Bzamination.  Eyelids:  cilia:  lachrymal  puncta:  mucosa, 
light  pink,  brick  red,  yellow,  puffy,  dropsical :  Ciliary  vessels  deep,  immov- 
able ;  nictitans  ;  transparentcomeaequally  smooth,  glossy,  with  clear  image 
at  all  points  :  foreign  body  on  cornea  :  corneal  ulcer  :  opacities  in  aqueous 
humor  :  iris  and  pupil :  corpora  nigra  :  changes  in  passing  from  darkness  to 
light :  pupillary  membrane  :  adhesions  of  iris  :  intraocular  pressure  :  con- 
tracted pupil :  hole  in  iris.  Oblique  focal  illumination  of  cornea,  aqueous 
humor,  iris,  lens,  Purkinje* Sanson  images. 

In  examining  animals  for  soundness  and  especially  the  horse  or 
dog,  the  condition  of  the  eye  must  be  made  one  of  the  most  im- 
portant subjects  of  inquiry,  as  a  disease  or  defect  may  render  the 
animal  altogether  unsuited  to  the  object  to  which  it  is  destined. 
As  in  every  other  field  of  diagnosis  thoroughness  is  largely  de- 
pendent on  the  adoption  of  a  system  which  will  stand  in  the  way 
of  any  flaw  being  too  hastily  overlooked.  Many  of  the  points  to 
be  noted  will  be  decided  at  a  glance,  yet  this  does  not  obviate  the 
necessity  of  turning  over  in  the  mind,  in  succession,  the  different 
points  of  inquiry,  and  directing  the  necessary  attention,  however 
hastily,  to  each  in  turn.  The  following  points  should  be  observed  : 

ist.  Are  the  eyelids  swollen,  hypertrophied  or  faulty  in 
form,  position  or  movements.     Faults  as  thus  indicated  may 


Systematic  Inspection  of  the  Eye.  323 

imply  any  one  of  a  great  variety  of  disorders  which  should  be 
followed  out  to  their  accurate  diagnosis.  It  may  be  bruises, 
lacerations,  punctures,  parasites,  conjunctivitis,  keratitis,  dropsy, 
anaemia,  hepatic  or  intestinal  parasitism,  nephritis,  paresis, 
entropion,  ectropion,  etc. 

2d.  Inspect  the  cilia  as  regards  form,  size  and  direction. 
Absence  or  wrong  direction  may  imply  disease  of  the  Meibonian 
glands,  infective  inflammation,  demodex  or  other  acarian  infest- 
ing, or  turning  in  or  out  in  inflammatory  conditions. 

3d.  See  that  the  lachrymal  puncta  are  open  and  that 
there  is  no  overdistension  of  the  sac.  The  overflow  of  tears 
and  the  swelling  of  the  caruncle  and  of  the  area  beneath  it  will 
often  indicate  such  trouble.  In  its  turn  it  may  imply  inflamma- 
tion of  the  duct,  and  obstruction  by  the  tenacious  mucopurulent 
product,  or  it  may  imply  merely  obstruction  of  its  lower  end  by  a 
dried  scab.  This  last  may  be  seen  in  the  horse,  on  the  floor  of  the 
false  nostril  at  the  line  of  junction  of  the  skin  and  mucosa,  and  in 
the  ass,  higher  up  on  the  inner  side  of  the  ala  nasi.  In  excep- 
tional cases  it  may  be  desirable  to  pass  a  stilet  through  the  canal 
from  the  puncta  downward  or  from  below  upward  to  determine 
whether  it  is  pervious. 

4th.  Determine  the  vascularity  of  the  conjunctiva.  When 
free  from  pigment  as  it  habitually  is  in  pigs  and  birds  this  is 
easily  done,  while  in  animals  like  the  horse,  in  which  the  bulbar 
portion,  which  covers  the  sclerotic,  is  largely  pigmented,  we  can 
scrutinize  only  the  pigment-free  parts.  In  health  there  should 
be  only  a  few,  fine,  pink  vessels  which  move  with  the  mucosa 
when  pressed  aside  on  the  bulb.  In  congestion  the  surface  may 
appear  brick  red,  and  the  vessels  are  irregular,  large,  tortuous  and 
are  seen  to  anastomose  at  frequent  intervals.  These  move  on  the 
bulb  when  pressed.  The  congestion  is  usually  deepest  on  the 
palpebral  mucosa  and  in  the  cut  de  sac,  and  may  be  whitened  for 
an  instant  by  pressure  through  the  eyelid.  To  expose  the  con- 
junctiva the  right  fore  finger  and  thumb  may  be  pressed  on  the 
upper  and  lower  lids  respectively  of  the  left  eye,  and  the  left 
finger  and  thumb  for  the  right,  allowing  them  to  slide  backward 
above  and  below  the  eyeball.  Another  method  is  to  seize  the 
cilia  and  edge  of  the  upper  eyelid  between  the  finger  and  thumb. 


324  Veterinary  Medicine, 

and  draw  it  downward  and  outward  from  the  bulb,  and  then  deftly 
invert  it  over  the  tip  of  the  finger.  In  the  old  the  unpigmented 
conjunctiva  may  appear  yellow  from  the  presence  of  subcon- 
junctival fat,  or  this  may  appear  at  any  age  from  hepatic  disease 
(distomatosis)  or  icterus.  It  is  swollen,  or  dropsical  in  anaemia, 
distomatosis,  etc. 

5th.  Examine  the  ciliary  vessels  whether  they  are  con- 
gested or  not.  These  are  distinguished  from  the  conjunctival 
vessels  in  that  they  radiate  in  straight  lines  outward  from  the 
margin  of  the  transparent  cornea  and  do  not  move  on  the  sclerotic 
under  pressure.  They  are  enlarged  and  very  red  in  congestion 
of  the  ciliary  circle  and  in  iritis.  In  eyes  devoid  of  pigment  over 
the  sclerotic,  there  is  usually  a  circular,  narrow,  white  zone  be- 
tween the  congested  area  and  the  margin  of  the  transparent  cornea. 

6th.  Examine  the  Membrana  Nictitans.  See  that  its  free 
margin  is  uniformly  smooth,  even,  and  thin  and  that  there  is  no 
swelling,  congestion  nor  morbid  growth  on  any  part  of  the 
structure. 

7th.  See  if  the  transparent  cornea  is  perfectly  and  uni- 
formly smooth,  transparent  and  glistening  and  if  it  reflects 
clear,  erect  images  of  all  objects  in  front  of  it.  The  image 
of  a  round  object  which  shows  any  irregularity  in  the  curvature 
of  its  margin  implies  a  deviation  from  an  uniform  curvature  of 
the  cornea  :  the  image  narrows  in  the  direction  of  the  smaller  arc 
and  broadens  in  the  direction  of  the  larger  one  (see  keratoscopy, 
and  corneal  astigmatism). 

8th.  A  foreign  body  on  or  in  the  cornea  may  be  recognized 
in  a  good  light,  but  better  and  more  certainly  under  focal  oblique 
illumination  (see  this  heading). 

9th.  A  corneal  ulcer  may  be  similarly,  recognized.  It  is 
made  more  strikingly  manifest  by  instilling  into  the  lower  cul  de 
sac  a  drop  of  a  solution  of  fluorescin  and  rubbing  it  over  the  eye 
by  moving  the  eyelids  with  the  finger.  This  will  stain  the  whole 
cornea.  If  now  the  excess  of  stain  is  washed  away  by  a  few 
drops  of  boric  acid,  the  healthy  part  of  the  cornea  is  cleared  up 
and  the  ulcer  retains  a  bright  yellowish  green  tint. 

loth.  Opacity  or  Floating  objects  in  the  aqueous  humor 
(flocculi  of  lymph,  pus,  pigment,  blood,  worms)  are  always  to  be 
looked  for.     They  may  be  detected  by  placing  the  eye  in  a  favor- 


Systematic  Inspection  of  the  Eye.  325 

able  light.  They  may  be  still  more  clearly  shown  under  focal 
illumination  (see  below). 

fith.  Changes  in  the  iris  and  pupil  may  also  be  noticed  in 
a  good  light.  The  surface  should  be  dark  in  the  horse,  and  of 
the  various  lighter  shades  in  the  smaller  animals,  but  in  all  alike 
clear,  smooth  and  polished,  without  variation  of  shade  in  spots  or 
patches  and  without  bulging  or  irregularity  at  intervals.  Apart 
from  the  congenital  absence  of  pigment  in  whole  or  in  part, 
which  may  be  found  in  certain  sound  eyes,  a  total  or  partial 
change  of  the  dark  iris  of  the  horse  to  a  lighter  red,  brown  or 
yellow  shade  implies  congestion,  inflammation,  or  exudation. 
The  corpora  nigra  in  the  larger  quadrupeds  should  be  unbroken, 
smooth,  rounded,  projecting  masses  outside  the  free  border  of  the 
upper  portion  of  the  iris.  They  should  show  a  clear,  polished  sur- 
face like  the  rest  of  the  iris.  The  pupil  should  be  evenly  oval  with 
its  long  diameter  transversely  (horse,  ruminant),  circular  (pig, 
dog,  bird),  or  round  with  an  elliptical  outline  on  contracting  and 
the  long  diameter  vertical  (cat).  It  should  contract  promptly  in 
light  and  dilate  as  quickly  in  darkness.  Place  the  patient  before 
a  window,  cover  one  eye  so  as  to  exclude  light,  then  cover  the 
other  eye  with  the  hand  and  quickly  withdraw :  The  pupil 
should  be  widely  dilated  when  the  hand  is  withdrawn  and  should 
promptly  contract,  and  it  should  actively  widen  and  narrow  al- 
ternately until  the  proper  accommodation  has  been  secured. 
Any  failure  to  show  these  movements  implies  a  lesion  in  the 
brain,  optic  nerve,  or  eye  which  impairs  or  paralyzes  vision, 
interferes  with  accommodation  or  imprisons  the  iris.  In  loco- 
motor ataxia  the  pupil  contracts  in  accommodation  to  distance,  but 
not  in  response  to  light. 

1 2th.  Other  causes  of  pupillary  immobility  include:  (a) 
Permanence  of  a  pupillary  membrane,  which  has  remained  from 
the  fcetal  condition  and  may  be  recognized  by  oblique  focal  illu- 
mination and  invariability  of  the  pupil :  (b)  Adhesion  of  the  iris 
to  the  capsule  of  the  lens — complete  or  partial — in  the  latter 
case  the  adherent  portion  only  remains  fixed,  while  the  remainder 
expands  and  contracts,  giving  rise  to  distortions  and  variations 
from  the  smoothly  curved  outline  :  (c)  Adhesion  of  the  iris  to 
the  back  of  the  cornea — complete  or  partial — and  leading  to 
similar  distortions  :  (d)  Glaucoma  in  which  intraocular  pressure 


326  Veterinary  Medicine, 

determines  a  permanent  dilatation  of  the  pupil  and  depression  of 
the  optic  disc :  (e)  The  pupil  is  narrowed  in  iritis,  and  is  less 
responsive  to  atropia  or  other  mydriatic :  (f )  Lesions  of  the  oculo- 
motor nerve  may  paralyze  the  iris  and  fix  the  pupil.  The  first 
three  and  the  fifth  of  these  conditions  may  be  recognized  by  the 
naked  eye,  alone,  or  with  the  aid  of  focal  illumination,  the  fourth 
>may  require  the  aid  of  the  ophthalmoscope  and  the  sixth  which 
cannot  be  reached  by  such  methods,  might  in  exceptional  cases 
be  betrayed  by  other  disorders  of  the  oculo-motor  nerve  (dropping 
of  the  upper  eyelid,  protrusion  of  the  eyeball,  squinting  outward). 

13th.  Coloboma  {fenestrated  iris),  and  lacerated  iris  are 
recognizable  by  the  naked  eye  in  a  good  light,  or  by  the  aid  of 
focal  illumination. 

14th.  Tension  of  the  eyeball  (Tonometry).  Elaborate  in- 
struments constructed  for  ascertaining  ocular  tension  are  of  very 
little  use  in  the  lower  animals.  The  simplest  and  most  practicable 
method  is  with  the  two  index  fingers  placed  on  the  upper  lid  to 
press  the  eyeball  downward  upon  the  wall  of  the  orbit  using  the 
one  finger  alternately  with  the  other  as  if  in  search  of  fluctuation. 
The  other  fingers  rest  on  the  niargin  of  the  orbit.  All  normal 
eyes  have  about  the  same  measure  of  tension  and  one  can  use  his 
own  eye  as  a  means  of  comparison.  The  educated  touch  is 
essential.  In  increased  tension,  the  sense  of  hardness  and  resist- 
ance, and  the  indisposition  to  become  indented  on  pressure  is 
present  in  the  early  stages  of  internal  ophthalmias  (iritis, 
choroiditis,  retinitis),  phlegmon  of  the  eyeball,  glaucoma, 
hydrophthalmos,  and  tumors  of  the  bulb. 

Oblique  Focal  Illumination. 

This  is  so  essential  to  clear  and  definite  conclusions  and  is  so 
easily  practiced  on  the  domestic  animals  that  every  veterinarian 
should  make  himself  familiar  wkh  the  method.  The  method  is 
based  on  the  fact  that  when  two  perfectly  transparent  media 
touch  each  other  a  reflection  of  luminous  rays  takes  place  only 
at  the  surface.  But  in  case  any  opacity  exists  in  any  part  of  the 
thickness  of  one  of  these  media,  it  reflects  the  rays  from  its  surface 
no  matter  what  may  be  its  position  in  the  medium.  Thus  corneal 
opacities  appear  as  gray  blotches  and  under  careful  focal  illumi- 


Systematic  Inspection  of  the  Eye,  327 

nation  it  may  be  determined  whether  these  are  on  the  conjunctival 
surface,  in  the  superficial  or  deeper  layers  of  the  cornea  or  in  the 
the  membrane  of  Descemet.  Similarly  cloudiness  or  floating  ob- 
jects in  the  aqueous,  reflect  the  luminous  rays,  and  so  with  opaci- 
ities  in  the  lens  or  its  capsule,  or  in  the  vitreous.  In  the  same  way 
the  surface  of  the  iris  and  corpora  nigra  may  be  carefully  scrutin- 
ized. For  satisfactory  examination  of  the  media,  back  of  the  iris, 
the  pupil  should  be  first  dilated,  by  instillation  under  the  lid  of  a 
drop  or  two  of  a  3  per  cent,  solution  of  atropia,  and  the  ex- 
amination proceeded  with  twenty  minutes  later.  Homatropin  is 
preferable  to  atropin  as  being  less  persistent  in  its  action,  and  less 
liable  to  produce  conjunctivitis.  If  it  fails  to  produce  the  requi- 
site dilatation,  it  may  be  followed  by  a  drop  of  a  4  per  cent, 
solution  of  hydrochloride  of  cocaine,  which  will  secure  a  free 
dilatation,  lasting  only  for  one  day  in  place  of  seven  days  as  with 
atropin.  The  cocaine  further  removes  pain  and  favors  the  full 
eversion  of  the  eyelids. 

The  instruments  required  for  focal  illumination  are  a  biconvex 
lens  of  15  to  20  diopters,  and  a  good  oil  lamp  or  movable  gas  jet. 
The  light  of  the  sun  is  not  satisfactory.  The  examination  ought 
to  be  conducted  in  a  dark  room,  or  less  satisfactorily  in  semi- 
darkness.  The  lamp  is  held  by  an  assistant  at  the  level  of  the 
eye  to  be  examined,  either  in  front  or  behind,  or  first  one  and 
then  the  other,  so  that  the  rays  of  light  may  fall  upon  the  eye 
obliquely.  If  the  lids  are  kept  closed  it  may  be  necessary  to  ex- 
pose the  cornea  by  pressing  on  the  lids  with  the  finger  and  thumb. 
The  light  is  held  8  or  10  inches  from  the  eye  and  the  lens  is  in- 
terposed between  it  and  the  eye  and  moved  nearer  and  more  dis- 
tant until  the  clearest  illumination  has  been  obtained  of  the  point 
to  be  examined.  In  this  way  every  accessible  part  of  the  eye 
may  be  examined  in  turn.  The  examiner  may  make  his  results 
more  satisfactory  by  observing  the  illuminated  surface  through 
a  lens  magnifying  three  or  four  diameters.  It  is  important  to 
observe  that  the  eye  of  the  operator  must  be  in  the  direct  line  of 
reflection  of  the  pencil  of  light. 

Cornea.  By  focusing  the  light  in  succession  over  the  different 
parts  of  the  surface  of  the  cornea,  all  inflammations,  vascularities, 
opacities,  ulcers,  and  cicatrices  will  be  shown  and  their  outlines 
clearly  defined.     By  illuminating  the  deeper  layers  of  the  cornea 


328  Veterinary  Medicine. 

proper,  the  lesions  of  keratitis,  opacities,  ulcers  and  cicatrices  will 
be  shown.  To  complete  the  examination  of  the  cornea  the  light 
should  be  focused  upon  the  iris  so  that  it  may  be  reflected  back 
through  the  cornea.  This  will  reveal  the  most  minute  blood- 
vessels, any  cell  concretions  on  Descemet's  membrane,  or  any 
foreign  body  in  the  cornea  which  may  have  been  overlooked. 

Aqueous  Humor.  Unless  the  cornea  is  densely  opaque,  the 
anterior  chamber  can  be  satisfactorily  explored  by  the  oblique 
focal  illumination.  The  cloudiness  or  milkiness  of  iritis  or 
choroiditis  furnishes  a  strong  reflection  from  its  free  particles  of 
floating  matter,  its  blood  and  pus  globules,  and  its  flocculi  of 
fibrine.  The  latter  have  usually  a  whitish  reflection,  the  blood 
elements  a  red  (hypohaema),  and  the  pus  a  yellow  (hypopyon). 
The  writhing  movements  of  a  filaria  scarcely  need  this  mode  of 
diagnosis.  Sometimes,  and  especially  in  the  horse,  detached 
flocculi  of  black  pigment  are  found  floating  free  in  the  aqueous 
and  are  highly  characteristic. 

By  this  illumination  one  can  easily  determine  the  distance  of 
the  cornea  from  the  iris  and  lens  (depth  of  anterior  chamber) 
which  is  lessened  by  the  forward  displacement  of  iris  and  lens  in 
undue  tension  in  the  vitreous  (glaucoma,  retinitis,  tumors, 
bladderworms)  ,or  of  the  iris  alone,  in  irido-choroiditis  with  accum- 
ulation of  exudate  in  the  posterior  chamber  of  the  aqueous.  The 
depth  of  the  anterior  chamber  may  increase  in  cases  of  luxation 
or  absence  of  the  lens  or  softening  and  atrophy  of  the  vitreous. 

The  adhesion  of  the  iris  to  the  back  of  the  cornea  may  be  satis- 
factorily demonstrated  by  focal  illumination. 

Iris.  The  lesions  of  the  iris  are  exceedingly  common  in  con- 
nection with  recurring  ophthalmia  in  the  horse,  and  examina- 
tions in  the  intervals  between  attacks  are  of  the  greatest  import- 
ance. The  eye  should  be  examined  as  already  stated,  at  a  window 
or  door,  and  if  available  by  the  aid  of  a  mirror.  Any  changes  in 
form  or  color,  or  luster  should  be  carefully  noted,  any  tension  of 
the  eyeball,  or  angularity  of  the  upper  lid,  and  any  slight  blue 
opacity  round  the  margin  of  the  cornea.  Then  the  prompt  or 
tardy  response  of  iris  and  pupil  to  light  and  darkness  must  be 
made  out.  To  complete  the  test  the  eye  should  be  treated  with 
homatropin  for  three-quarters  of  an  hour  and  with  cocaine  for  ten 
or  fifteen  minutes,and  then  subjected  to  oblique  focal  illumination. 


Systematic  Inspection  of  the  Eye,  329 

With  partial  posterior  synechia  the  rest  of  the  pupil  is  found 
dilated  while  the  attached  portion  extends  inward  remaining  fixed 
to  the  capsule  of  the  lens.  If  the  synechia  is  complete  no  dilata- 
tion whatever  has  occurred.  The  edges  of  the  adherent  iris 
extend  inward  as  adherent  projections,  and  any  exposed  portion 
of  the  lens  is  likely  to  show  black  points,  the  seat  of  previous 
adhesions  that  have  been  broken  up.  In  such  cases  the  periphery 
of  the  iris  bulges  forward  from  the  accumulation  behind  it  of 
aqueous  humor  or  inflammatory  exudate  which  cannot  escape. 
The  discoloration  of  the  iris  as  the  result  of  inflammation,  stands 
out  more  definitely  under  the  fuller  illumination. 

Crystalline  lens.  In  exploring  the  crystalline  lens  or  its  cap- 
sule for  opacities  (cataracts)  oblique  focal  illumination  can  be  em- 
ployed to  the  very  best  advantage,  if  the  pupil  has  first  been 
widely  dilated  by  homatropine  and  cocaine.  The  light  is  con- 
centrated on  all  parts  of  the  anterior  capsule  in  turn,  then  in  suc- 
cession on  the  different  layers  of  the  lens  at  all  points  and  finally 
on  the  posterior  capsule.  The  striking  reflection  from  any 
points  of  opacity  whether  pigmentary,  gray  or  pearly  white  is 
diagnostic,  not  only  of  cataract,  but  of  its  exact  position — an- 
terior or  posterior,  capsular  or  lenticular. 

Purkinje-Sanson  images.  If  the  flame  of  a  candle  is  passed 
in  front  of  the  eye,  at  a  suitable  distance,  in  a  darkened  room, 
and  the  observer  looks  into  the  eye  obliquely  from  the  opposite 
side,  he  observes  three  images  of  the  flame,  reflected  respectively 
from  the  front  of  the  cornea,  from  the  anterior  surface  of  the 
lens  and  from  the  back  of  the  lens.  The  image  from  the  cornea 
is  erect,  bright  and  clearly  defined  :  that  from  the  front  of  the 
lens  is  still  erect,  but  larger  and  dimmer,  because  the  difference 
between  the  index  of  refraction  of  the  aqueous  and  lens  is 
very  slight :  the  third  image,  which  is  smaller  and  clearer  than 
the  last,  is  inverted,  because  the  surface  of  reflection  on  the  back 
of  the  lens  acts  as  a  concave  mirror.  The  beginner  may  at  first 
find  it  difficult  to  make  out  the  image  from  the  front  of  the  lens 
but  with  a  little  care  he  can  do  so,  and  then  by  moving  the  light 
he  should  cause  each  image  to  pass  over  all  parts  of  the  reflecting 
surface  in  turn.  Any  unevenness  or  opacity  at  any  point  of  the 
reflecting  surface,  will  cause  the  image  reflected  from  it  to  be- 
come blurred  or  diffused  as  it  passes  over  it  and  thus,  not  the 


330  Veterinary  Medicine, 

existence  only,  but  the  exact  seat  of  such  opacity  is  easily  demon- 
strated. Opacities  on  the  cornea  cause  blurring  of  the  bright, 
erect  image  of  the  flame  as  it  passes  over  that  part :  opacities  on 
the  anterior  capsule  of  the  lens  blur  the  dim,  erect  image  when 
passed  over  them :  finally,  opacities  in  the  body  of  the  lens  or 
on  its  posterior  capsule,  blur  the  small  inverted  image  as  it  passes 
over  them. 

Add  to  this  method  the  oblique  focal  illumination  and  the 
images  of  the  flame  reflected  from  the  three  mirror  surfaces 
(cornea,  anterior  and  posterior  lens  surfaces)  are  made  much 
clearer  and  more  distinct  than  in  any  other  way.  To  do  this 
effectively  the  convex  lens  should  be  held  so  as  to  focus  the  flame 
in  the  air  nearly  in  front  of  the  cornea.  The  Purkinje-Sanson 
images  are  made  very  definite  and  clear.  If  the  lens  is  ap- 
proached nearer  to  the  eye  so  as  to  throw  the  image  of  the  flame 
within  or  behind  the  lens,  a  gray  phosphorescent  streak  of  light 
is  seen  in  the  depth  of  the  pupil.  This  is  due  to  the  laminated 
structure  of  the  lens  as  well  as  to  the  fact  that  the  lens  itself  is 
not  perfectly  transparent  even  in  its  normal  condition.  The  ab- 
sence of  the  lens  or  its  dislocation  and  displacement  downward, 
below  the  line  of  vision  may  be  inferred  from  the  absence  of  this 
gray  luminous  reflection  under  this  test. 


OPHTHAI.MOSCOPE. 

Principle  of  ophthalmoscope  :  Angle  of  incident  and  angle  of  reflection 
in  same  line,  light  close  to  one  side  of  the  eye,  reflected  into  it  by  a  mirror, 
having  a  hole  in  the  centre  for  eye  of  observer.  Opacities  show  a  dense 
white  in  transparent  media  :  if  in  front  of  lens  move  with  rolling  of  eye  :  if 
behind  in  opposite  direction.  To  see  fundus  must  use  biconvex  lens, 
Emmetropic  eye :  myopic  :  hypermetropic.  Static  refraction.  Mydriatics  : 
Atropine,  homatropine,  daturine,  duboisine,  hyoscyamine. 

In  the  healthy  eye,  the  pupil  and  iris,  and  in  cataract,  even  the 
opaque  anterior  capsule  of  the  lens,  can  be  clearly  seen.  The  re- 
flection of  the  pupil,  however,  is  dark  and  no  object  back  of  the 
iris  can  be  observed.  The* reason  of  the  diCFerence  is  that  the 
rays  of  light,  entering  through  the  whole  cornea,  are  reflected  at 
the  same  angle  at  which  they  strike  the  surface  of  the  iris.    The 


Ophthcdmoscope,  331 

angle  of  incidence  is  the  same  as  the  angle  of  reflection.  In  the 
hollow  fundus  of  the  eye,  however,  the  light  entering  through 
the  narrow  pupil,  strikes  the  fundus  at  a  point  which  is  hidden 
from  the  observer,  behind  the  iris,  and  being  reflected  by  the 
concave  fundus,  in  exactly  the  same  line  along  which  it  entered, 
it  remains  invisible.  To  illuminate  the  fundus  of  the  eye,  for 
the  observer,  his  line  of  vision  must  be  made  exactly  the  same  as 
that  in  which  the  pencil  of  light  enters  the  fundus.  This  is  best 
effected  by  reflecting  the  light  into  the  eye  by  the  aid  of  a  small 
plane  or  concave  mirror  having  a  hole  in  the  center  through 
which  the  observer  looks  into  the  pupil.  The  concave  mirror 
gives  the  stronger  illumination,  but  the  plane  article  is  more 
easily  manipulated  and  tends  to  cause  less  active  contractions  of 
the  pupil.  This  is  the  simplest  form  of  ophthalmoscope.  For 
careful  examination  of  the  fundus  of  the  eye,  it  is  best  to  have 
the  subject  in  a  dark  chamber,  with  a  single  large  flame  of  an  oil 
lamp  or  gas  (electric  light  with  an  obscure  globe  may  answer). 
The  light  is  held  behind  and  on  the  same  side  as  the  eye  to  be 
examined,  at  the  level  of  the  eye  and  the  perforated  mirror  and 
the  eye  of  the  observer  are  kept  from  10  to  20  inches  in  front  of 
the  eye  and  also  at  the  same  level.  For  the  horse  or  ox  under 
favorable  conditions  in  a  stall,  the  light  of  day  coming  from  a  fan- 
sash  over  the  door  may  serve  the  purpose.  Nicholas  assures  us 
that  it  may  be  accomplished  even  under  the  shadow  of  a  shed  or  a 
tree.  In  such  a  case  it  is  better  not  to  have  too  much  glare  of 
light  as  the  reflection  from  cornea  and  lens  may  prevent  accurate 
observation.  A  somewhat  cloudy  day  may  therefore  prove  ad- 
vantageous. 

In  focusing  the  reflected  light  on  the  cornea,  and  then  on  the 
pupil  and  lens,  any  opacities  in  these  will  be  shown  as  a  grayish 
nebular  reflection  or  a  denser  white  according  to  their  degree  of 
opacity.  The  opacities  in  the  cornea  or  aqueous,  in  front 
of  the  axis  of  vision  in  the  lens,  move  in  the  same  direction  and 
to  the  same  degree  as  the  eye  rolls,  while  opacities  on  the  pos- 
terior capsule  or  in  the  vitreous,  move  in  a  direction  opposite  to 
the  motions  of  the  eye,  and  to  a  degree  corresponding  to  their 
distance  back  of  the  lens.  Thus  if  the  eye  looks  downward  such 
opacities  move  upward  ;  if  it  looks  upward  they  move  downward  ; 
if  it  looks  inward  they  move  outward ;  and  if  it  looks  outward 
they  move  inward. 


332  Veterinary  Medicine, 

To  secure  an  image  of  the  fundus  of  the  eye,  including  the 
entrance  of  the  optic  nerve  (optic  papilla),  the  tapetum,  the 
pigmentary  surface  and  retina  and  vessels,  accommodation  must 
be  made  for  the  normal  refraction  of  the  eye  of  the  patient,  and 
even  for  that  of  the  observer. 

In  the  emmetropic  (normal)  eye,  the  rays  leave  the  surface 
of  the  cornea  parallel  to  each  other  and  it  may  be  possible  for  the 
observer  to  secure  a  good  image  on  his  retina,  without  the  aid  of 
lenses.  In  the  myopic  (short  sighted)  eye  they  assume  a  con- 
vergent course  on  leaving  the  cornea,  and  to  secure  a  satisfactory 
image  a  biconcave  or  plano-concave  lense  must  be  interposed  be- 
tween the  cornea  of  the  patient  and  the  eye  of  the  observer. 

In  the  hypermetropic  (long  sighted)  eye,  the  rays  diverge  in 
leaving  the  cornea  of  the  patient,  and  a  convex  lens  must  be 
interposed  between  this  and  the  eye  of  the  observer,  in  order  that 
the  rays  may  be  focused  on  the  eye  of  the  observer. 

To  adapt  the  vision  to  the  diCFerent  eyes  the  modem  ophthalmo- 
scope is  furnished  with  a  series  of  lenses  concave  and  convex,  any 
one  of  which  can  be  moved  behind  the  hole  in  the  mirror  to  suit 
the  demands  of  the  particular  case. 

To  make  a  satisfactory  examination  the  pupil  should  be  dilated 
as  for  oblique  focal  illumination.  A  i  :  200  solution  of  apomor- 
phia  may  be  instilled  into  the  eye  (a  drop  or  two)  and  in  20  to  25 
minutes  a  satisfactory  dilatation  will  have  been  secured.  The 
eCFect  of  the  homatropin  will  usually  have  disappeared  in  twenty- 
four  hours. 

Determination  of  Static  Refraction. 

This  can  best  be  done  in  the  lower  animals  by  determining  the 
strength  of  the  lens  required  to  render  clear  the  image  of  its 
fundus.  By  knowing  the  refracting  power  of  the  lens,  we  may 
ascertain  what  deviation  from  the  normal  refraction  there  is  in 
the  eye  under  observation. 

In  making  this  test  the  mirror  of  the  ophthalmoscope  must  be 
brought  closely  to  the  eye  of  the  patient — i  to  2  inches. 

If  in  such  a  case  and  without  the  use  of  any  lens  a  distinct 
image  of  the  fundus  is  obtained,  and  if  this  is  rendered  less  dis- 
tinct by  interposing  the  lowest  convex  lens  in  front  of  the  eye  of 
the  observer,  the  eye  is  emmetropic. 


ophthalmoscope,  333 

If  the  ophthalmoscopic  mirror  without  a  lens  gives  an  indis- 
tinct vision  of  the  fundus,  and  if  the  image  is  rendered  clear  by 
interposing  one  of  the  convex  lenses,  the  eye  is  hypermetropic. 
The  strength  of  the  convex  lens,  -f  i,  +  2  or  +  3,  dioptrics  will 
give  the  measure  of  the  hypermetropia. 

If,  on  the  contrary,  the  ophthalmoscopic  mirror  gives  an  indis- 
tinct image  of  the  fundus,  which  is  rendered  even  more  indis- 
tinct by  the  interposition  of  a  convex  lens,  but  is  cleared  up  and 
rendered  definite  by  a  concave  lens,  the  patient  is  myopic.  The 
strength  of  the  concave  lens  used  will  give  the  degree  of  myopia^ 
—  I  dioptric,  —  2  dioptrics,  etc. 

The  tendency  in  the  horse  is  constantly  to  slight  long-sighted- 
ness, but  the  deviation  is  rarely  fpund  to  be  serious  either  in  this 
direction  or  in  that  of  astigmatism. 

Mydriatics. 

Dilation  of  the  pupil  by  mydriatics  (mydriasis,  dilation  of  the 
pupil)  is  a  most  important  means  of  diagnosis,  and  therefore  a 
knowledge  of  the  action  of  the  different  mydriatics  is  essential. 
The  mydriatics  in  common  use  not  only  dilate  the  pupil,  but  also 
paralyze  the  ciliary  body  and  the  power  of  accommodation  in 
ratio  with  the  strength  of  the  solution  employed.  This  determines 
an  adaptation  of  the  eye  to  the  farthest  point  of  vision  and  holds 
it  there  until  the  action  of  the  mydriatic  passes  off  and  normal 
power  of  accommodation  is  restored.  In  short  it  renders  the  sub- 
ject long  sighted,  during  its  action. 

Atropine  the  alkaloid  of  atropa  belladonna  is  the  most  gener- 
ally available  and  persistent  of  the  mydriatics,  and  is  in  most  com- 
mon use.  It  is  usually  employed  as  sulphate  of  atropine,  though 
some  prefer  the  nitrate,  the  salicylate  or  the  borate  to  obviate  the 
danger  of  atropinism.  This  form  of  poisoning  may  show  in  the 
occurrence  of  conjunctivitis  and  in  case  of  one  attack  the  suscepti- 
bility to  atropine  is  greatly  to  be  dreaded,  so  that  it  should  never 
again  be  used  on  the  same  subject.  The  real  cause  of  atropinism 
is  uncertain,  it  has  been  variously  ascribed  to  too  great  acidity  or 
alkalinity  or  to  micro-organisms  growing  in  the  solution.  Hence 
the  importance  of  using  the  antiseptic  salts  of  atropine,  and  of 
testing  the  solution  to  see  that  it  is  exactly  neutral  before  it  is 
applied. 


334  Veterinary  Medicine, 

The  strength  of  the  solution  of  atropine  is  an  important  con- 
sideration. Bonders  found  that  i  :  1 20  of  water  produced  a  full 
effect,  while  Jaarsma  obtained  the  full  effect  in  one  hour  from  a 
drop  of  a  solution  of  one  to  twelve  hundred  of  water.  The  action 
on  carnivora  (dogs^nd  cats)  is  equivalent  to  that  on  man,  while 
on  the  herbivora  (rabbit,  horse,  ox,  sheep)  it  is  somewhat  less, 
and  on  birds  very  slight  indeed.  On  diseased  eyes  a  large  amount 
may  be  required,  and  with  senechia  (adhesion  of  the  iris  to  the 
capsule  of  the  lens)  dilatation  may  be  impossible.  The  full 
effect  may  last  24  hours,  and  accommodation  may  remain  very 
imperfect  for  1 1  days. 

The  direct  action  of  atropine  on  the  eye  is  shown  in  dilatation 
of  the  pupil  of  the  frog  after  the  eye  has  been  detached  from  all 
connection  with  heart  or  brain,  by  excision.  It  acts  also  in  the 
normal  system  through  reflex  nervous  action,  since,  after  division 
of  the  sympathetic  trunk  going  to  the  eye,  that  eye  does  not  di- 
late so  much  under  atropia  as  the  opposite  eye. 

Atropine  is  usually  employed  by  lodging  a  drop  in  the  pouch 
of  the  conjunctiva  (inside  the  lower  lid),  and  from  this  it  makes 
its  way  into  the  aqueous  humor,  for  if  that  liquid  is  transferred  to 
the  conjunctiva  of  another  animal  it  causes  dilatation.  Puncture  of 
the  cornea  with  evacuation  of  the  aqueous  humor  lessens  the  action 
of  the  atropine.  Atropine  dilatation  is  increased  by  following  it 
with  cocaine  which  causes  contraction  of  the  iridian  vessels,  the 
antithesis  of  the  dilatation  of  the  vessels  which  occurs  when  the 
cornea  is  perforated  and  the  pressure  of  the  aqueous  humor  is  re- 
moved. 

Atropine  is  one  of  the  most  potent  poisons  and  must  be  used 
with  caution  especially  in  the  carnivora  and  omnivora.  The 
danger  lies  not  alone  in  the  absorption  from  the  conjunctiva,  but 
also  from  the  escape  of  the  liquid  through  the  lachrytno-nasal 
duct,  to  the  nose  and  later  to  the  actively  absorbing  mucosae  of 
the  lungs  and  stomach. 

The  symptoms  of  general  poisoning  are  :  rapid  pulse,  vertigo, 
weakness  of  posterior  limbs,  general  prostration  and  thirst  or 
dryness  of  the  throat. 

Homatropine  is  an  oily  liquid  produced  by  the  action  of 
muriatic  acid  on  the  cyanate  of  atropine.  With  hydrobromic 
acid  it  forms  a  readily  crystallizable  salt,  the  solution  of  which 


Wounds  of  the  Eyelids,  335 

acts  on  the  eye  like  atropine,  but  more  promptly  and  transiently. 
One  drop  of  a  solution  of  one  to  one  hundred  and  twenty,  usually 
gives  in  twenty  minutes,  full  pupillary  dilation  and  complete 
paralysis  of  accommodation  which  lasts  only  for  twenty-four 
hours.  Add  to  this  that  there  is  little  danger  of  constitutional 
disturbance  and  poisoning,  and  homatropine  must  be  accepted  as  a 
more  desirable  agent  than  atropine.  It  is  especially  to  be  preferred 
in  cases  of  senility  with  shallow  anterior  chambers,  and  in  glau- 
coma, in  which  atropine  tends  to  aggravate  the  lesion. 

Daturine,  the  alkaloid  of  datura  stramonium  is  a  potent  my- 
driatic, causing  pupillary  dilatation  in  a  solution  of  one  to  one 
hundred  and  sixty  thousand  of  water.  It  appears  to  be  identical 
with  atropine. 

Duboisine,  the  alkaloid  of  duboisia  myoporoides  is  also  a 
potent  mydriatic.  Jaarsma  found  that  a  solution  of  the  sulphate, 
of  one  to  three  thousand,  paralyzed  accommodation  for  twenty- 
four  hours.  It  acts  more  promptly  than  atropine  but  is  more 
poisonous. 

Hyoscy amine,  the  alkaloid  of  hyoscyamus  niger,  is  also 
strongly  mydriatic.  One  drop  of  an  one  to  three  hundred  solu- 
tion of  the  sulphate  paralyzed  accommodation  for  from  seventy- 
five  to  one  hundred  hours.  Risley  found  it  to  act  more  promptly 
than  atropine,  and  to  be  less  dangerous  than  duboisine. 


WOUNDS  OF  THE  EYELIDS. 

Traumas  :  bites,  lacerations,blows,  penetrating  wounds,  gunshot,  scratches, 
kicks.  Upper  lid  or  commissure.  Reparatory  power  of  eyelid.  Danger  of 
distortion.  Treatment :  sutures,  plaster,  shellac,  collodion,  gelatine.  Prick's 
gelatine,  birdlime,  sterilisation  :  Quilled  and  twisted  suture.  Position  in 
stall.    Metallic  guard  for  eye. 

Causes.  Traumatic  injuries  of  the  eyelids  are  especially  com- 
mon in  the  horse  mainly  because  of  his  exposure  in  connection 
with  the  services  required  of  him.  In  a  team  he  is  liable  to  be 
bitten  by  one  of  his  fellows,  or  the  lid  may  be  caught  on  nails, 
in  turning,  or  on  hooks  upon  harness,  chains  or  wagons.  It 
is  sometimes  injured  by  a  blow  from  a  club  or  whiplash,    or 


336  Veterinary  Medicine. 

by  knocking  the  head  against  solid  objects  that  he  failed  to 
see  on  account  of  the  blinds.  Again  the  injury  will  come  from 
running  against  prongs  of  bushes  or  trees,  or  of  stump  fences. 
Occasionally  a  blow  with  the  horn  of  an  ox  or  cow  is  the  cause, 
but  this  is  much  more  frequent  with  the  bovine  races.  Then 
again  gunshot  wounds  are  found  in  all  animals.  In  sheep  the 
eyelids  sometimes  suffer  from  bites  of  dogs,  while  in  dogs  and 
cats,  the  teeth  and  claws  are  the  main  causes  of  injury.  These 
smaller  animals  also  suffer  from  brutal  blows  and  kicks. 

Nature,  Wounds  of  the  eyelids  almost  invariably  affect  the 
upper  lid,  because  of  its  extra  size  and  prominence.  Sometimes 
one  commissure  or  the  lower  lid  is  the  injured  part. 

Clean  incised  wounds  are  rare,  while  lacerations,  with  or  with- 
out contusions  are  the  common  experience.  The  laceration  often 
extends  through  the  free  margin  of  the  lid,  and  then  to  one 
side,  mostly  the  outer,  in  a  direction  more  or  less  parallel  to  the 
tarsus.  The  result  is  that  the  detached  flap  drops  downward 
exposing  a  greater  or  less  portion  of  the  bulb  covered  with  blood. 
The  conjunctiva,  the  cornea,  the  sclerotic  or  iris  may  be  impli- 
cated in  the  lesion  in  different  cases,  so  that  such  wounds  are  of 
the  most  varied  degree  of  gravity.  If,  however,  the  lesion  is 
confined  to  the  lid,  and  in  the  absence  of  absolute  detachment  of 
the  flap,  or  severe  contusion,  a  good  repair  may  be  confidently 
hoped  for.  The  vascularity  and  reparatory  powers  of  the  eyelid 
are  unusually  great,  and  the  looseness  of  the  skin,  connective  tis- 
sue, mucosa,  and  even  the  muscles  is  such  that  they  do  not  draw 
injuriously  upon  the  edges  of  the  wound  to  disturb  the  process 
of  cicatrisation.  If  the  two  opposing  ends  of  the  divided  tarsal 
cartilage  are  kept  in  accurate  apposition,  the  elasticity  of  this 
structure  serves  to  preserve  the  even  contour  of  the  palpebral 
margin,  and  the  adhesion  or  granulation  process  between  the  edges 
of  the  wound,  soon  becomes  firm  enough  to  prevent  further  dis- 
placement. Even  when  one- half  of  the  eyelid  is  torn  loose,  remain- 
ing attached  only  by  a  narrow  portion,  reunion  without  any  un- 
sightly distortion  is  not  to  be  despaired  of.  In  case  of  a  mere  vertical 
laceration  on  the  other  hand,  the  case  is  very  simple  and  hopeful. 
Even  when  a  portion  of  a  lid  has  been  completely  torn  off  and 
lost,  the  loose  textures  of  the  remaining  part,  often  appear  to 
stretch  in  the  process  of   healing  so  that   a  fairly  serviceable^ 


Wounds  of  the  Eyelids.  337 

though  by  no  means  an  aesthetic  covering  for  the  eye  may  remain. 
This  may  serve  for  a  common  work  horse,  but  the  unsightli- 
ness  would  necessarily  debar  him  from  use  in  a  carriage  or  as  a 
saddle  horse.  The  imperfect  protection  too,  exposes  the  eye 
to  rainstorms,  hail  and  snow,  as  well  as  to  dust,  and  greatly 
predisposes  to  conjunctivitis. 

Treatment.  One  can  trust  implicitly  to  the  extraordinary  re- 
paratory  power  of  the  eyelids,  yet  so  unsightly  is  any  distortion 
of  these  parts,  that  the  greatest  pains  must  be  taken  to  obviate 
loss  of  substance,  or  unevenness  or  puckering  in  healing.  The 
points  to  be  mainly  sought  for  are  the  perfect  coaptation  of  the 
divided  edges,  and  the  restraining  of  the  patient  from  interrupting 
the  healing  process  and  breaking  loose  the  forming  adhesions,  by 
rubbing  the  eye. 

Inconsiderable  wounds  of  the  skin  may  be  simply  stitched 
together  with  sterilized  catgut.  Then  the  intervals  between  the 
stitches  may  be  approximated,  dried,  and  covered  with  strips  of 
sticking  plaster,  or  with  shellac,  collodion  or  gelatine.  Prick's 
gelatine  is  made  by  dissolving  fine  gelatine  in  a  i  per  cent,  solu- 
tion of  corrosive  sublimate  and  adding  about  10  per  cent,  of  glycer- 
ine, perfecting  the  admixture  by  the  aid  of  heat.  When  wanted 
for  use  it  may  be  melted  by  heat  and  applied  on  the  skin  with  a 
camePs  hair  brush.  Bird  lime  may  be  used  as  a  substitute. 
Sterilization  must  be  sought  by  the  use  of  sublimate  lotion  i :  2000, 
or  boric  acid  2  :  100.  Formerly  the  edges  were  kept  in  close 
opposition  by  the  use  of  quilled  sutures,  the  stitches  passed  around 
the  quills  being  inserted  at  the  usual  distances  while  the  quills, 
applied  against  the  edges  of  the  wound  kept  them  smooth  and 
even  and  obviated  puckering.  Or,  perhaps  better,  the  twisted 
suture  may  be  employed,  the  edges  being  brought  together  by 
pins  placed  close  together  and  a  silk  thread  carried  around  each 
in  figure  of  8,  and  spirally  from  pin  to  pin  along  the  entire  length. 
If  one  pin  comes  out  it  ought  to  be  promptly  replaced  and  the 
whole  left  in  place  until  a  firm  adhesion  is  established.  The 
points  of  the  pins  are  cut  off  short  so  that  there  may  be  no  risk  of 
their  pricking. 

With  any  method  the  horse  or  ox  may  be  turned  in  his  stall  so 
that  his  tail  may  be  toward  the  manger  and  his  face  outward,  and 
he  may  be  tied  by  two  halters  to  the  two  posts,  right  and  left.  His 
22 


338  Veterinary  Medicine, 

food  may  be  furnished  in  a  sack  hung  from  the  ceiling  and  cut 
down  one  side.  In  this  way  the  animal  may  be  absolutely  pre- 
vented from  rubbing  the  itching  sore  against  any  solid  body,  and 
thereby  interrupting  the  healing  process.  Another  method  is  to 
apply  a  hood  of  stiflF  material  with  a  metalKc  guard  for  the  face, 
having  bars  extending  from  above  downward  and  arched  outward 
so  that  they  shall  eflFectually  protect  the  eye  in  any  attempt  at 
rubbing. 


DEFICIENCY  OF  THE  EYELIDS.     COLOBOMA  PALPE- 
BRARUM. 

The  term  coloboma  representing  merely  a  hiatus  or  deficiency 
is  applied  to  different  parts  of  the  eye  according  as  there  may  be 
a  lack  of  substance  of  the  part  in  question  : — Coloboma  palpe- 
brarum (deficiency  of  the  palpebrae  or  lids),  C.  iridis  (perfora- 
tion of  the  iris),  and  C.  choroidese  (partial  absence  of  the 
choroid). 

Coloboma  palpebrarum  is  usually  congenital  and  takes  the 
form  of  a  vertical  notch  on  the  upper  lid,  separating  its  two 
lateral  parts  into  independent  flaps.  According  to  the  breadth 
and  depth  of  the  notch  are  the  extent  of  the  exposure  of  the 
bulbar  conjunctiva  and  the  liability  to  irritation  and  infection  by 
foreign  bodies.  The  same  condition  of  things  will  occur  trau- 
matically  and  require  identical  measures  of  repair.  These  con- 
sist in  paring  the  edges  of  the  notch  and  bringing  them  accu- 
rately together  with  cat  gut,  silk  or  quilled  suture,  the  approxi- 
mation being  rendered  more  perfect  by  the  application  of  col- 
lodion, shellac  or  gelatine  mixture  (see  wounds  of  eyelids).  The 
vascularity  and  extensibility  of  the  tissues  of  the  lids  greatly 
favor  a  kindly  healing.  Rubbing  of  the  eye  must  be  guarded 
against  as  advised  under  wounds  of  the  eyelids. 


ORGANIC  UNION  OF  THE  EYELIDS.  ANKYLOBLE- 
PHARON. NARROWED  FISSURE  BETWEEN  THE 
LIDS.     BLEPHAROPHYMOSIS. 

Complete  closure  of  the  palpebral  fissure  has  been  seen  as  a 
congenital  infirmity  in  sheep,  dogs  and  cats,  while  the  partial 
closure  has  been  found  in  all  classes  of  animals  as  the  result  of 
chronic  conjunctivitis  and  contraction  of  the  exudation  in  under- 
going organization.  Narrowing  of  the  fissure  gives  the  appear- 
ance of  a  small  eye,  so  that  a  progressive  diminution  is  usually 
supposed  to  come  from  a  reduction  in  size  of  the  bulb,  though  no 
actual  atrophy  of  that  organ  has  taken  place.  In  drooping  of 
the  upper  lid  (ptosis)  too,  the  fissure  is  reduced  and  the  illusion 
of  an  atrophy  of  the  eyeball  is  induced.  The  closure  of  the 
fissure  may  come  from  blepharospasm^  as  the  result  of  irritants 
in  the  eye,  or  even  of  nervous  disorder. 

Treatment.  In  case  of  complete  closure  of  the  palpebral 
fissure,  the  skin  is  picked  up  with  forceps  and  an  incision  is  made 
between  the  two  tarsi  into  the  conjunctival  sac.  Then  with 
probe  pointed  scissors,  or  a  grooved  director  and  bistuory  the  in- 
cision is  carried  between  the  tarsi  to  the  proper  position  for  the 
internal  and  external  canthi.  During  healing  the  lids  should  be 
frequently  bathed  with  a  boric  acid  solution,  and  an  ointment  of 
the  same  with  vaseline  should  be  applied  to  prevent  adhesion. 

When  the  trouble  consists  in  a  drawing  together  of  the  skin  at 
the  outer  canthus,  the  result  of  inflammation,  the  adhesions  are 
separated  by  a  horizontal  incision  leading  outward  from  the  line 
of  the  angle.  The  edges  of  the  conjunctiva  and  skin  are  then 
sutured  together,  so  as  to  prevent  further  adhesion  and  the  part 
treated  as  an  ordinary  wound.     This  is  known  as  canthoplasty. 

Ptosis  coming  from  tumors  on  the  lid,  or  excess  of  fat  in  its 
substance,  or  from  oculo-motor  disease  must  be  treated  according 
to  indications.  The  same  remark  applies  to  spasm  of  the  orbicu- 
lar muscle  (  blepharospasm  ) ,  whether  clonic  or  tonic.  In  domestic 
animals  the  removal  of  the  cause  (foreign  body,  eyelash),  will 
usually  succeed. 
339 


WIDENED  PALPEBRAL  FISSURE. 

After  wounds  of  the  outer  canthus  the  union  of  the  edges  may 
remain  imperfect  so  that  the  fissure  is  enlarged  and  the  eye  un- 
duly exposed.  The  case  is  still  worse  if  the  wound  has  deviated 
from  the  horizontal  and  has  involved  the  orbicular  muscle,  the 
divided  ends  of  which  continue  to  draw  the  edges  apart,  and 
cause  a  constant  overflow  of  tears  (epiphora).  Enlargement  of 
the  bulb  or  its  protrusion  by  reason  of  a  swelling  beneath  it  may 
give  rise  to  the  same  appearance  (exophthalmos). 

Treatment,  Pare  the  edges  of  the  upper  and  lower  lids  at  the 
outer  canthus  and  bring  them  together  by  sutures. 


LAGOPHTHALMUS.     INABILITY  TO  CLOSE  EYELIDS. 

This  is  called  hare-eye  (lagos,  hare)  from  the  fact  that  the 
hare  habitually  keeps  the  eyelids  open.  It  is  mostly  due  to 
spasm  of  the  levatores  palpebrae,  or  to  undue  size  of  the  orbicular 
opening.  It  may,  however,  accompany  ectropion,  exophthalmos, 
and  enlargement  or  swelling  of  the  eyeball  from  any  cause. 
Bayer  has  seen  cases  in  diseases  of  the  trifacial  nerve,  in  neo- 
plasms in  the  orbit  and  in  buphthalmus. 

Cases  of  the  kind  are  especially  liable  to  irritation,  inflamma- 
tion and  ulceration  due  to  foreign  bodies  falling  on  the  exposed 
bulb. 

The  treatment  is  largely  that  of  the  attendant  condition  ectro- 
pion, tumor,  etc.,  which  may  be  consulted. 


340 


ADHESION   OF  THE   EYELID   TO   THE   BULB.    SYM- 
BLEPHARON. 

Causes :  Conjunctivitis,  bums,  operation  and  other  wounds.  In  front  of 
or  behind  the  reflection  of  the  mucosa  from  eye  to  lid.  Prevention.  Treat- 
ment :  section  of  adhesion,  and  vaseline,  etc.  Two  edges  of  healthy  mu- 
cosa sutured  together  over  the  sore.  When  fornix  is  implicated  mucosa  is 
transplanted. 

This  is  liable  to  occur  to  a  greater  or  less  extent,  in  all  animals, 
in  connection  with  violent  conjunctivitis,  bums  and  operation 
and  other  wounds.  It  has  been  divided  into  anterior  and  pos- 
terior sytnblepharon,  the  former  being  an  union  in  front  of  the 
normal  reflection  of  the  conjunctiva  from  the  lid  upon  the  bulb 
(fornix),  and  the  latter  involving  the  fornix  in  the  substance  of 
the  adhesion.  The  afiterior  form  by  anchoring  the  lid  to  the 
eyeball  is  much  more  likely  to  induce  blindness,  but  it  has  the 
compensation  that  the  union  may  be  broken  up  and  the  parts 
healed  without  subsequent  reunion.  In  the  posterior  form  the 
eye  can  be  better  exposed  and  vision  retained,  its  repair  is  much 
more  difficult  demanding  transplantation  of  skin  or  mucous  mem- 
brane on  to  the  sore,  and  even  then  the  granulation  tissue  being 
continuous  from  bulb  to  eyelid  may  so  contract  in  healing  as  to 
leave  matters  no  better  than  before. 

These  adhesions  not  only  restrict  the  movements  of  the  lids, 
preventing  their  opening  and  the  exposure  of  the  bulb,  but  they 
also  anchor  the  bulb  itself,  and  hamper  its  movements,  neces- 
sitated for  vision.  In  all  cases  therefore  of  wounds,  burns,  abra- 
sions and  ulcers,  of  the  palpebral  and  bulbar  mucosae  it  is  highly 
important  to  take  precautions  against  the  formation  of  such  con- 
nections. Any  forming  adhesions  must  be  broken  up  day  by  day 
and  the  surfaces  must  be  kept  apart  in  the  intervals  by  borated 
or  iodoformed  vaseline. 

In  a  small  anterior  symblepharon  the  connections  may  be  cut 
through  and  subsequent  adhesion  prevented  by  the  frequent  in- 
troduction of  iodoformed  vaseline,  and  if  need  be,  by  the  daily 
separation  of  the  surfaces  by  a  probe.  When  this  fails  a  plastic 
operation  may  be  resorted  to,  the  mucosa  on  the  inner  side  of  the 
341 


342  Veterinary  Medicine. 

lid  being  incised  in  a  vertical  direction  a  short  distance  on  each 
side  of  the  sore  and  the  inner  edges  accurately  stitched  together. 
The  raw  surface  left  on  the  bulb  thus  comes  in  contact  only  with 
the  healthy  mucous  strips  on  the  eyelid,  which  have  been  drawn 
together  over  the  seat  of  the  former  sore,  and  the  two  new  raw 
surfaces  formed  on  the  lid  are  well  to  each  side  of  the  sore  on 
the  bulb,  and  "are  in  contact  with  its  healthy  mucosa  only.  Thus 
no  two  raw  surfaces  can  come  in  contact,  and  adhesion  is  obviated. 
When  the  fornix  is  implicated  mucous  membrane  from  the 
mouth,  vulva,  the  bronchia  of  the  rabbit,  or  the  skin  of  the  frog 
must  be  transplanted  after  the  requisite  incision  of  the  cicatrix 
has  been  made. 


INFLAMMATION  OF  THE  EYELIDS.       BLEPHARITIS. 

Phlegmon.  Causes  :.tranmas,  skin  disease.  Symptoms  :  swelling,  red- 
ness, distortion,  infiltra  ion,  semi- closed  lids,  scabs,  sloughs,  abscess. 
Tenderness.  Itching.  In  eczema  papules,  vesicles,  weeping  eye.  Treat- 
ment: antiseptic  astringent  lotions,  almond  oil,  vaseline,  zinc  oxide, 
salicylic  acid«  boric  acid,  starch,  xeroform,  pyoktannin  ;  for  eczema,  mer- 
cury oxides,  silver  nitrate,  collargol. 

Conjunctivitis  will  be  treated  later,  and  under  the  present  head 
there  will  be  considered  only  the  phlegmon  of  the  outer  structures. 

Causes,  This  lesion  may  come  from  two  distinct  causes,  traum- 
atism and  skin  disease.  The  traumatisms  in  horses  and  cattle  are 
bruises  sustained  in  rolling,  especially  during  colics,  in  striking 
the  head  against  posts,  poles,  shafts  and  other  solid  bodies,  in 
enduring  blows  with  horns  or  clubs,  or  frictions  by  the  halter  or  in 
putting  on  a  collar.  Dogs  suffer  especially  from  blows  with  clubs 
and  kicks  from  men  or  animals.  All  may  suffer  from  wounds  of  the 
lids,  and  from  extensions  of  eczema,  acariasis  and  other  skin  dis- 
eases. 

The  symptoms  consist  in  swelling,  redness,  distortion,  and  often 
extensive  infiltration  of  the  lid,  some  times  eversion  with  exposure 
of  the  reddened  conjunctiva,  usually  abrasion,  contusion,  puncture 
or  laceration,  semi-closed  eye,  the  upper  eyelid  being  compara- 
tively immovable  (ptosis),  and  the  formation  of  scabs,  sloughs, 
or  abscess.     There  may  be  extreme  tenderness,  or,  more  com- 


Inflammation  of  the  Eyelids,     Blepharitis,  343 

monly,  intense  itching.  Where  eczema  exists  there  may  be 
found  minute  shot-like  papules  at  times  surmounted  by  small 
vesicles  and  the  skin  disease  is  continuous  backward  upon  the 
face.  When  abscess  forms,  the  rounded  swelling  and  manifest 
fluctuation  will  betray  its  presence.  Usually  the  eye  waters  and 
the  side  of  the  cheek  is  wet  and  the  hairs  matted  by  a  whitish 
coagulated  lymph  and  mucus. 

Treatment,  In  the  early  stages  without  scabs,  sloughs,  or  ab- 
scess, antiseptic  astringent  lotions  are  in  place.  Weak  solutions 
of  zinc  sulphate,  boric  acid  and  morphine  may  be  kept  applied 
on  a  light  bandage.  Or  silver  nitrate  i  gram  to  i  oz.  water  may 
be  applied  daily  with  a  fine  brush. 

When  scabs  and  crusts  have  formed  they  may  be  softened  by 
the  application  of  almond  oil,  and  then  removed.  The  surface 
may  then  be  dusted  with  a  bland  antiseptic  powder  such  as : 
zinc  oxide  10  parts,  salicylic  acid  i  part ;  or  boric  acid  and  starch 
equal  parts  ;  or  iodoform  ;  or  xeroform.  Or  unctuous  applica- 
tions may  be  used  :  zinc  oxide  10,  salicylic  acid  i,  vaseline  10  ; 
or  iodoform  i,  vaseline  5.  Or  a  watery  application  may  be  used, 
such  as  the  silver  lotion  or  that  of  pyoktannin  i  :  1000, 

For  eczema  yellow  oxide  of  mercury  i,  to  vaseline  10,  has  an 
excellent  reputation.     It  may  be  alternated  with  pyoktannin. 

When  abscess  has  formed  it  should  be  incised  in  a  line  parallel 
to  the  free  border  and  the  resulting  cavity  injected  with  the  silver 
or  the  pyoktanin  solution. 

In  all  cases  the  patient  must  be  fastened  as  for  wounds  of  the 
lids  so  that  he  cannot  rub  the  eye. 

For  eczema,  acariasis  and  other  skin  diseases  the  special  treat- 
ment appropriate  to  the  disease  should  not  be  omitted. 


CEDEMA  OF  EYELIDS. 

In  anthrax,  malignant  oedema,  disease  of  heart,  kidney  or  liver,  distoma- 
tosis,  trichiniasis,  wasp  stings,  urticaria,  petechial  fever.  Treatment :  cor- 
rect general  disorder,  remove  local  irritant,  antiseptic  astringents. 

An  oedematous  condition  of  the  eyelids  with  or  without  in- 
flammatory conditions  may  be  due  to  local  disease  or  it  may  be 
the  result  of  more  general  disorder.     In  anthrax  districts  any  of 


344  Veterinary  Medicine, 

the  herbivora,  but  especially  cattle  and  sheep,  are  liable  to  a  dif- 
fuse anthrax  of  the  eyelid  with  a  special  petechial  or  brownish 
condition  of  the  palpebral  conjunctiva.  Malignant  cedema  and 
other  local  bacteridian  affections  affect  the  loose  textures  of  the 
eyelid  in  a  similar  manner,  but  with  extrication  of  gas  and  crack- 
ling under  pressure.  Such  cases  are  complicated  by  local  in- 
flammation. When  in  the  absence  of  inflammation  the  lids  pit 
on  pressure,  one  should  seek  for  some  disease  of  the  heart,  kid- 
ney or  liver,  also  for  indications  of  similar  dropsical  effusions  in 
other  parts  of  the  body.  Distomatosis  and  to  a  less  extent,  pul- 
monary and  duodenal  strongylosis  are  especially  common  factors 
in  sheep.  In  distomatosis  (liver  rot)  a  simultaneous  dropsy  is 
often  present  in  the  intermaxillary  space,  the  chest  or  the  ab- 
domen. The  puffiness  of  the  eye  is  especially  marked  in  the  pal- 
pebral conjunctiva,  and  is  exposed  by  everting  the  eyelid  over 
the  tip  of  the  finger.  In  trichinosis  in  man  and  less  frequently 
in  swine,  dropsy  of  the  eyelid  is  often  present  at  the  end  of 
the  first  week.  Other  swellings  of  the  lids  partaking  more  of  the 
nature  of  inflammation,  result  from  the  stings  of  wasps,  hornets 
and  other  insects,  from  urticaria  (in  horses  especially)  and  from 
petechial  fever  in  solipeds. 

In  treating  such  cases  the  general  disorder,  if  present,  must  be 
first  attended  to,  then  the  removal  of  any  local  irritant,  and  finally 
the  antagonizing  of  any  local  inflammation  or  infection.  Astrin- 
gent and  antiseptic  lotions  are  especially  called  for. 


EMPHYSEMA  OF  THE  EYELIDS. 

This  has  been  already  referred  to  as  occurring  in  malignant 
cedema,  black  quarter  and  other  gas  producing  infections.  It 
may  also  come  from  lacerations  made  in  puncturing  the  lachrymal 
sac,  and  from  fracture  of  the  margin  of  the  orbit — the  air  enter- 
ing the  connective  tissue  in  this  case  from  the  cavities  of  the 
nasal  sinuses.  The  lid  feels  puffy  and  crackles  when  pressed  and 
apart  from  a  general  infection  it  requires  only  soothing  and  anti- 
septic dressings. 


DISEASE  OF  THE  MEIBOMIAN   GLANDS.     BLEPHAR- 
ADENITIS.     SEBORRHCEA. 

This  is  a  blepharitis  of  the  edges  of  the  lids  which  are  swollen, 
red,  and  incrusted  along  their  margins  with  scabs  and  sebaceous 
concretions.  When  this  scurf  is  removed  the  skin  is  found  to  be 
red,  tender  and  glistening.  The  glands  are  the  seat  of  conges- 
tion, and  produce  a  modified  secretion  in  excess,  which  dries  into 
crusts  instead  of  preserving  its  normal  oleaginous  consistency. 
As  these  glands  open  into  the  follicles  of  the  eyelashes,  their 
walls  are  implicated  and  shedding  of  the  lashes  is  a  common  re- 
sult. It  may  be  assumed  that  this  affection  is  often  associated 
with  the  proliferation  of  microbes  in  the  glands  and  gland  ducts, 
while  in  other  forms  the  presence  of  acari  is  the  controlling  fac- 
tor. Wilson  found  the  demodex  foUiculorum  in  the  Meibomian 
glands  of  the  horse,  Oschatz  in  those  of  the  sheep,  and  others  in 
those  of  the  dog. 

Treatment,  Smear  the  margins  of  the  lids  with  vaseline  and 
when  the  crusts  have  been  thoroughly  softened  wash  them  off 
with  Castile  soap  and  warm  water.  Then  dress  the  margin  with 
the  ointment  of  the  yellow  oxide  of  mercury  i,  in  vaseline  lo. 
If  demodex  is  suspected  they  may  be  squeezed  out  and  the  lids 
washed  frequently  with  spirits  of  wine  as  a  solvent. 


HORDEOLUM.     STYE.     ACNE. 

Like  acne  of  the  skin  in  general,  this  consists  in  inflammation 
and  suppuration  of  a  hair  follicle  and  sebaceous  gland.  The 
whole  lid  or  a  large  part  of  it  may  be  swollen,  but  by  stroking  it 
with  the  finger,  a  hard,  rounded,  very  tender  spot  will  be  de- 
tected, and  as  the  disease  advances  this  develops  a  minute  collec- 
tion of  pus.  A  specially  wide  orifice  favors  the  entrance  of  the 
pus  microbes,  and  the  onset  of  the  disease.  It  has  been  noted  in 
dogs  (Frohner). 

For  abortive  treatment  Fick  recommends  dry  heat  from  a  pocket 
handkerchief  or  a  heated  teaspoon.  If  pus  is  present  it  must  be 
evacuated,  and  recurrence  guarded  against  by  cleanliness  and 

345 


346  Veterinary  Medicine, 

antiseptics.       Use  pyoktannin   solution    (i  :  looo),  or  mecuric 
chloride  (i  :  5000)  or  yellow  oxide  of  mercury  ointment. 


CHALAZION. 


This  is  a  pea-like  tumor  growing  from  the  tarsal  cartilage,  its 
flattened  side  toward  the  mucosa,  which  is  red  and  angry,  and 
its  round  surface  toward  the  skin.  When  manipulated  between 
the  fingers  it  moves  with  the  tarsus.  It  is  usually  of  sl6w  growth 
and  may  contin\ie  for  years  apparently  unchanged.  Some  have 
thought  it  tuberculous,  but  its  true  nature  is  uncertain.  Warner 
records  the  disease  in  the  horse. 

Treatment  consists  in  incision  and  removal  of  the  tumor,  cur- 
retting  of  the  cavity,  and  after  antiseptic  douching,  suturing  the 
lips. 


TUBERCULOSIS  OF  THE  EYELID. 

Described  by  Jewsejenke  in  the  lower  lid  of  birds,  this  is  mani- 
fested by  small,  hard  round  knots,  covered  by  bluish  red,  or  yel- 
lowish red  skin,  and  when  incised  showing  a  characteristic  miliary 
tubercle,  with  bacilli  and  sometimes  a  caseated  centre.  It  is 
treated  by  incision,  curretting  and  caustics. 


TURNED-IN  EYELASH.     TRICHIASIS. 

Sometimes  an  eyelash  grows  inward  so  as  to  impinge  upon  the 
front  of  the  eyeball,  or  even  to  extend  between  this  and  the  eye- 
lid. The  condition  exists  in  entropion  but  trichiasis  is  rather  the 
deviation  of  one  or  two  cilia  by  reason  of  their  false  direction,  in- 
dividually. It  may  occur  as  the  result  of  a  pre-existing  inflam- 
mation affecting  the  edge  of  the  lid  and  the  follicle,  and  the 
offending  hair  is  not  only  badly  directed  but  small  and  shrunken 
as  well.  On  this  account  it  is  not  always  easy  to  recognize  it, 
and  accordingly  in  cases  of  conjunctivitis  without  apparent  cause 


Entropion,      Turning  in  of  the  Eyelid,  347 

it  is  well  to   examine  carefully  with  the  aid  of  oblique   focal 
illumination. 

Treatment  consists  in  pulling  out  the  offending  hair  with  ciliary 
forceps,  avoiding  bending  it  lest  it  break  off  short  and  become  at 
once  more  irritating  and  more  difficult  of  extraction.  In  case 
the  hair  grows  anew  in  the  same  direction  extract  it  anew  and 
destroy  its  root  with  the  electric  cautery.  Or  the  cilia  being 
drawn  out  with  a  smooth  ring  or  spatula,  an  incision  is  made  on 
the  inner  side  of  this,  between  the  tarsal  cartilage  and  the  orbic- 
ular muscle.  The  skin  is  drawn  out  by  plaster,  or  stitch,  or 
plastic  operation,  and  the  wound  allowed  to  heal  by  granulation. 


ENTROPION.      TURNING  IN  OF  THE  EYELID. 

In  foals,  puppies,  hounds,  with  narrow  fissure,  and  conjunctivitis,  or 
tarsitis.  Permanent  bandaging,  orbicularis  spasm.  Symptoms  :  disappear- 
ance of  tarsus  and  lashes  by  involution.  Treatment :  in  spasm  fix  by  plas- 
ter ;  suture  skin  :  excise  elliptical  section  of  skin  and  suture  edges  together. 
Release  cicatrices. 

Inversion  of  the  eyelid  or  a  portion  of  it,  with  consequent 
trichiasis,  conjunctivitis  and  lachrymation  has  been  met  with  con- 
genitally  in  foals  (Aubry,  Bourdeau,  Hamon)  and  puppies 
(Cadiot,  Almy).  Hounds  have  especially  suffered.  In  the  older 
animals  it  is  largely  determined  by  abnormally  narrow  fissure, 
and  by  old  standing  disease  of  the  conjunctiva  or  tarsus,  with 
cicatricial  contraction  or  adhesion.  Persistent  bandaging  turns 
in  the  cilia  and  contributes  to  entropion.  Finally  a  persistent 
spasm  of  the  orbicularis  muscle  may  bring  it  about. 

Symptoms,     Trichiasis  is  usually,  though  not  always,  present. 

In  any  case  the  tarsus  is  turned  inward  so  as  to  press  upon  the 
front  of  the  bulb,  or  even  to  disappear  completely.  Thickening 
and  distortion  of  the  lid  is  a  not  infrequent  condition. 

Treatment,  In  case  of  simple  spasm  clip  or  shave  the  hairs 
from  the  lid  corresponding  to  the  lesion,  and  close  to  the  tarsus 
attach  a  strip  of  plaster.  When  firmly  adherent  draw  it  suffi- 
ciently to  efface  the  entropion  and  attach  it  to  the  skin  of  the 
face. 


348  Veterinary  Medict7ie, 

This  failing,  Gaillard's  sutures  may  succeed.  With  a  pair  of 
forceps  with  looped,  transversely  elongated  blades,  pinch  up  skin 
and  muscle  sufficient  to  correct  the  entropion,  and  passing  a 
needle  twice  through  this  fold  with  an  interval  of  3  m  m.,  tie 
the  suture  over  a  small  roll  of  cotton.  The  stitches  may  be  re- 
moved in  two  days  and  the  cicatrices  may  permanently  obviate 
the  deformity. 

The  older  plastic  operation  is  more  trustworthy  :  The  skin  of 
the  affected  lid  is  pinched  up  to  such  an  extent  in  length  and 
breadth,  as  to  correct  the  entropion  and  is  then  excised  with 
sharp  scissors  or  bistuory  so  as  to  leave  a  long  elliptical  sore. 
The  edges  of  this  are  then  carefully  sutured  together  and  the  re- 
sulting union  corrects  deformity.  Frohner  excises  a  circular 
piece  of  skin  and  allows  it  to  contract  and  heal  by  granulation. 
In  case  the  entropion  is  caused  by  an  old  standing  cicatrix,  it  may 
be  necessary,  first,  to  make  a  careful  incision  along  the  edge  of 
the  lid  so  as  to  separate  the  tarsus  and  conjunctiva  from  the  cilia 
and  Meibomian  ducts,  and  then  to  proceed  with  the  plastic  oper- 
ation on  the  skin. 


TURNING  OUT  OF  THE  EYELID.      ECTROPION. 

In  large  dogs,  in  old  age,  debility,  conjunctival  swelling,  cicatrized  skin 
of  lids,  distortions  of  lids.  Symptoms :  exposure  of  pelpebral  mucosa* 
weeping  eyes,  conjunctival  hypertrophy  (chemosis).  Treatment:  tcarify 
or  excise  a  fold  of  muco'ta,  astringent  antiseptics,  Snellen's  suture,  Diefen- 
bach's  operation,  Wharton  Jones  operation. 

This  is  much  more  common  than  entropion,  but  much  less  in- 
jurious as  the  tarsi  and  lashes  do  not  irritate  the  conjunctiva.  It 
is  especially  common  in  large  dogs  (hounds,  mastiff)  and  usually 
affects  the  inner  part  of  the  lower  lid.  Old  age  and  debility  con- 
tribute materially  to  the  condition,  the  lack  of  tone  or  paresis 
being  an  important  factor.  It  may,  however,  occur  in  any  ani- 
mal, from  conjunctivitis  and  swelling  of  the  mucosa,